| NPI | 1063882074 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELISA TORELL Owner 770-218-9005 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC008616) |
| Enumeration Date | 2015-10-02 |
| Last Update Date | 2015-10-02 |