| NPI | 1275751448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROL STEPHENS Office Manager 706-543-1145 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 261QC1500X Clinic/Center Community Health |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2024-07-29 |