| NPI | 1316223969 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HUEY R KIDD Physician 334-636-5311 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 261QR1300X Clinic/Center, Rural Health |
| 313M00000X Nursing Facility/Intermediate Care Facility | |
| 314000000X Skilled Nursing Facility | |
| Enumeration Date | 2011-10-27 |
| Last Update Date | 2019-01-16 |