| NPI | 1750913349 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LUCILLE M TRAVIS CEO 678-978-4947 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center, Primary Care |
| Additional Taxonomies | 251J00000X Nursing Care |
| Enumeration Date | 2020-02-11 |
| Last Update Date | 2023-10-22 |