| NPI | 1245340264 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID WARD CEO 706-788-3234 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2022-05-03 |