| NPI | 1023371416 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DARLA LARAE BESLEY Owner 678-571-8131 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2012-06-20 |