| NPI | 1013258409 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | EVETTE MOORE-WOODRUFF COO 478-508-0152 | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 1300005661) | 
| Enumeration Date | 2013-03-08 | 
| Last Update Date | 2013-03-08 |