| NPI | 1023492162 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KATHERINE MCLEOD CEO 478-787-4266  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: GA 26859)  | 
| Enumeration Date | 2015-07-18 | 
| Last Update Date | 2015-07-18 |