| NPI | 1124773932 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHETIVA L JOHNSON Manager 229-873-8956 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 251J00000X Nursing Care |
| Enumeration Date | 2022-02-21 |
| Last Update Date | 2022-03-02 |