| NPI | 1639585219 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE OFORI Contact Person 912-376-0986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QU0200X Clinic/Center, Urgent Care |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QP2300X Clinic/Center, Primary Care | |
| Enumeration Date | 2014-07-03 |
| Last Update Date | 2014-07-03 |