| NPI | 1902477052 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EARLENE JOINER DANIELS CFO 912-527-1088 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2021-07-08 |
| Last Update Date | 2024-01-11 |