| NPI | 1588215610 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | REGINA FITZGERALD CEO 770-961-1997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care |
| Additional Taxonomies | 251J00000X Nursing Care |
| 261QD0000X Clinic/Center Dental | |
| Enumeration Date | 2019-09-20 |
| Last Update Date | 2019-09-20 |