| NPI | 1033579412 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY SPIRES CEO 229-888-6559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-02-29 |
| Last Update Date | 2025-07-01 |