| NPI | 1003176538 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY SCHUMANN LASSETER Owner 706-307-2780 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC006359) |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2012-05-17 |