| NPI | 1144694621 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JANET MCPEEK CFO 234-521-7213 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2015-11-20 |
| Last Update Date | 2019-05-02 |