| NPI | 1053748947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIAM DAVID MILLER Owner 706-442-9127 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC004441) |
| Enumeration Date | 2013-10-09 |
| Last Update Date | 2013-10-09 |