| NPI | 1962443697 |
|---|---|
| Other Name | COSBY CENTER |
| Entity Type | Organization |
| Authorized Contact | LARRY A STANIFER CEO 865-509-0055 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2010-02-02 |