| NPI | 1023381191 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMI SMITH Business Manager 912-265-7660 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health (Licence: GA LPC003217) |
| Enumeration Date | 2012-02-20 |
| Last Update Date | 2012-02-20 |