| NPI | 1417174657 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LARRY A STANIFER CEO 423-613-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2010-06-30 |