| NPI | 1306217294 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLIS I EFOBI Executive Director 770-879-7707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: GA 060727) |
| Enumeration Date | 2015-10-17 |
| Last Update Date | 2015-10-17 |