NPI | 1467094649 |
---|---|
Entity Type | Organization |
Authorized Contact | ROBERT B TUCKER CEO 229-468-9166 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
Enumeration Date | 2019-10-09 |
Last Update Date | 2021-10-08 |