| NPI | 1811761448 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BILLIE INCLAN Hr 404-564-9345 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2023-11-14 |
| Last Update Date | 2023-11-14 |