technological infrastructure / healthcare needs / specific purposes and services / /
MedicalCondition
hypertension / /
Organization
Notary Public My Commission / C. No Board / No Board / Board of Directors/Trustees / North Carolina Department of Health and Human Services / A. The Board / Internal Revenue Service / Organization mission / Any / The Board / An / office of State Budget and Management / Medicare / / /
Position
Chairman / Executive Director / Psychologist / supervisor / Contractor / counsel / duly authorized representative / Board member / officer / director / FTEs Employed Physician Nurse Practitioner Physician / NC General / ineligible Contractor / Assistant Certified Nurse Midwife Registered Nurse / Organization Official / Second Authorizing Official / Official Seal / Board Chair / Licensed Clinical Social Worker / officer / employee or agent / North Carolina General / Authorized Official / General / Organization Chairman / Executive Director / officer / Agency Head and Chief Fiscal Officer / /
SFY[removed]Rural Health Center Operations Grant Program Innovation Project ORGANIZATIONAL INFORMATION & SIGNATURE SHEET