| NPI | 1912365263 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARVA MELISSA MONROE Publice Health Nurse 404-612-5835 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: GA 261QF00X) |
| Enumeration Date | 2016-02-02 |
| Last Update Date | 2016-02-02 |