| NPI | 1073338919 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANISHA HODGE CFO 678-935-9939 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QC1500X Clinic/Center, Community Health |
| 261QH0100X Clinic/Center, Health Services | |
| 261QM1000X Clinic/Center, Migrant Health | |
| Enumeration Date | 2024-11-16 |
| Last Update Date | 2024-11-16 |