| NPI | 1043587595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN DOHENY Owner/Operator 706-575-1833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA 003696) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: 12786) |
| Enumeration Date | 2011-11-29 |
| Last Update Date | 2011-11-29 |