| NPI | 1609151760 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CELESTA CAROL LISENBEE President/Owner 706-533-5469 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: GA 121014269) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2011-10-19 |