| NPI | 1013390590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MEGAN DAMON Compliance And Administrative Spec 678-771-8468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2015-07-02 |
| Last Update Date | 2025-10-31 |