| NPI | 1003247628 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AVERY MITCHELL Owner/COO 678-316-6997 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC007152) |
| Enumeration Date | 2013-12-07 |
| Last Update Date | 2026-04-09 |