| NPI | 1194908954 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANE MILLER LUNN President/CEO 850-385-4494 |
| Organization Subpart ? | |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-12-14 |
| Last Update Date | 2020-12-10 |