| NPI | 1174529192 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TODD SHIFFLET CEO 770-887-1668 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QU0200X Clinic/Center, Urgent Care |
| Enumeration Date | 2005-06-23 |
| Last Update Date | 2022-07-21 |