| NPI | 1235492398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALBERT B GRANDY CEO 912-527-1000 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2012-06-22 |
| Last Update Date | 2020-01-29 |