| NPI | 1922301472 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENA DOUSE CEO 912-721-6701 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2010-12-06 |
| Last Update Date | 2024-09-06 |