| NPI | 1063654341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSIE ANN BEAL CFO 334-420-5001 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2009-04-01 |
| Last Update Date | 2023-11-29 |