| NPI | 1619548062 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARMILA ALEXANDER ANDERSON Medical Coding & Billing Supervisor 704-874-1907 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-07-07 |
| Last Update Date | 2021-07-07 |