| NPI | 1750734372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TINA WRIGHT Credentialing 912-721-6704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2016-07-19 |
| Last Update Date | 2023-11-08 |