NPI | 1891978854 |
---|---|
Entity Type | Organization |
Authorized Contact | R B TUCKER CFO 229-468-9160 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2007-12-13 |
Last Update Date | 2024-10-22 |