| NPI | 1811602378 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAVANAUGH CHANDLER CEO 912-275-8028 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-01-19 |
| Last Update Date | 2023-01-19 |