| NPI | 1629460142 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBRA TOWNSEND VP Of R Cm 470-440-1647 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: FL HCC10390) |
| Enumeration Date | 2015-02-20 |
| Last Update Date | 2017-09-08 |