| NPI | 1053929786 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IVANDA MELINDA POSTELL Clinician 770-284-9092 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 261QD1600X Clinic/Center Developmental Disabilities |
| 261QH0100X Clinic/Center Health Service | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2020-07-20 |
| Last Update Date | 2020-07-20 |