| NPI | 1720108590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE JONES-THEAKER CEO 912-318-3947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2007-03-29 |
| Last Update Date | 2018-06-12 |