| NPI | 1093754905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIE WREN DENMARK CEO 478-237-2638 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2015-07-31 |