| NPI | 1578534871 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELIA R HORTON Director Of Operations 910-483-2853 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Additional Taxonomies | 305S00000X Point of Service |
| Enumeration Date | 2006-01-27 |
| Last Update Date | 2010-10-05 |