| NPI | 1053101246 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ORANDA VERONICA PRINCE CEO 678-350-8322 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363L00000X Nurse Practitioner |
| Additional Taxonomies | 103T00000X Psychologist |
| 251S00000X Community/Behavioral Health | |
| 261Q00000X Clinic/Center | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2025-05-09 |
| Last Update Date | 2025-05-09 |