| NPI | 1376207985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBERT BONDS TUCKER CEO 229-468-9166 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-10-29 |
| Last Update Date | 2021-10-29 |