| NPI | 1326594714 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE JONES-THEAKER CEO 912-318-3947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: GA 20843) |
| Enumeration Date | 2016-08-26 |
| Last Update Date | 2016-08-26 |