| NPI | 1629309117 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELIQUE S GREER CEO 228-374-2494 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2010-01-22 |
| Last Update Date | 2024-08-16 |