NPI | 1972892727 |
---|---|
Entity Type | Organization |
Authorized Contact | BURT WALLER Executive Director 901-260-8551 |
Organization Subpart ? | No |
Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) |
Enumeration Date | 2011-04-01 |
Last Update Date | 2012-01-23 |