| NPI | 1629263058 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA M TRIPP CEO 910-567-6194 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-09-10 |
| Last Update Date | 2018-02-01 |