| NPI | 1588663421 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | E THOMAS ANDREWS President 678-843-8502 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2011-01-31 |