| NPI | 1760658587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUNE A DIPOLITO Executive Director 912-764-6906 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center (Licence: GA LPN068072) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2008-05-01 |