| NPI | 1043730682 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA B VELEZ Sole Proprietor 770-322-4619 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-06-25 |
| Last Update Date | 2022-02-25 |