| NPI | 1003311580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL JEAN DRAKE CEO Manager 478-442-3156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163W00000X Registered Nurse (Licence: GA RN105510) |
| Additional Taxonomies | 163WN0800X Registered Nurse, Neuroscience (Licence: GA RN105510) |
| 261QR1300X Clinic/Center, Rural Health (Licence: GA RN105510) | |
| 261QV0200X Clinic/Center, VA (Licence: GA RN105510) | |
| Enumeration Date | 2018-03-27 |
| Last Update Date | 2018-03-27 |