| NPI | 1952723298 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANA U ALLEN CEO 706-996-8251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2014-01-06 |
| Last Update Date | 2014-04-07 |