| NPI | 1194258327 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | JENNIE WREN C DENMARK CEO 478-237-6262 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) | 
| Enumeration Date | 2017-04-05 | 
| Last Update Date | 2017-04-05 |