| NPI | 1932586203 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFFREY W HOWARD CFO 423-317-9344 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) (Licence: TN L000000014836) |
| Enumeration Date | 2015-05-06 |
| Last Update Date | 2020-09-30 |