| NPI | 1861666455 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LYNN W PRICE Insurance/Billing Manager 478-864-3448 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2008-04-15 |
| Last Update Date | 2011-11-21 |