| NPI | 1639857477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHARMILA ALEXANDER ANDERSON Revenue Cycle Manager 704-874-1907 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-07-11 |
| Last Update Date | 2023-07-11 |