| NPI | 1023658523 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA M STOKES VP Of Finance 678-843-8530 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-01-13 |
| Last Update Date | 2020-01-13 |