| NPI | 1073367249 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M HOLMES Chief Operations Officer 704-316-6561 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2024-04-15 |
| Last Update Date | 2024-05-01 |