| NPI | 1104244706 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GARY LAWRENCE JAMES Executive Director 678-535-7216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2014-04-01 |