| NPI | 1134849219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GREGORY M BOUNDS CEO 910-267-1237 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2022-08-30 |
| Last Update Date | 2023-04-18 |