| NPI | 1316286842 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERTA R GREEN Executive Director 678-535-7216 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 261QP2300X Clinic/Center, Primary Care | |
| 291U00000X Clinical Medical Laboratory | |
| Enumeration Date | 2013-02-04 |
| Last Update Date | 2013-02-04 |