| NPI | 1477853174 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA L MELSON Director 678-938-9841 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: GA 004455) |
| Enumeration Date | 2010-10-27 |
| Last Update Date | 2010-10-27 |