| NPI | 1356927594 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUSTIN ROYCE JOHNSTON Executive Director 205-644-8641 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health |
| Enumeration Date | 2021-03-18 |
| Last Update Date | 2021-09-03 |