| NPI | 1649540105 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GWENDOLYN ELISE REED CEO 704-695-1475 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2011-12-30 |
| Last Update Date | 2011-12-30 |