| NPI | 1366066243 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAWN WRIGHT Revenue Cycle Manager 404-564-7749 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2020-06-05 |
| Last Update Date | 2022-05-04 |