| NPI | 1154747590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KATHERINE K MCLEOD CEO 478-254-7223 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: GA 26859) |
| Enumeration Date | 2014-03-10 |
| Last Update Date | 2014-03-10 |