| NPI | 1558041244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH BRYAN HAYNES CEO 276-496-4492 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-07-19 |
| Last Update Date | 2023-07-19 |