| NPI | 1013670934 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KRISTA SMITH CEO 770-410-4894 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| 261QH0100X Clinic/Center Health Service | |
| Enumeration Date | 2021-10-18 |
| Last Update Date | 2021-10-18 |