| NPI | 1073164539 |
|---|---|
| Doing Business As | MARION MAT |
| Entity Type | Organization |
| Authorized Contact | JOSEPH BRYAN HAYNES CEO 276-496-4492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2019-09-26 |
| Last Update Date | 2021-06-07 |