| NPI | 1356682959 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SUSAN A JOHNSON CFO 770-279-3142 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2013-03-06 |
| Last Update Date | 2013-09-27 |