| NPI | 1912904897 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARSHA E THIGPEN Executive Director 409-983-1161 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2005-07-07 |
| Last Update Date | 2018-11-09 |