| NPI | 1467717611 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARILYN TATHAM Provider Enrollment Manager 828-692-4289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2012-07-12 |
| Last Update Date | 2020-03-06 |