| NPI | 1881834232 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMIEKA SHANNELL RANKIN Cna 336-641-6124 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QC1500X Clinic/Center, Community Health (Licence: NC 265670) |
| Enumeration Date | 2009-02-25 |
| Last Update Date | 2009-02-25 |