| NPI | 1831197938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN K ELLERBY Chief Executive Officer 336-272-1050 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2011-08-29 |