| NPI | 1710625983 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA M HOLMES COO 704-316-6561 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2022-05-26 |
| Last Update Date | 2022-08-15 |