| NPI | 1073038063 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTINE OWEN Officer 706-781-3155 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 322D00000X Residential Treatment Facility, Emotionally Disturbed Children | |
| 385HR2055X Respite Care, Respite Care, Mental Illness, Child | |
| Enumeration Date | 2017-08-10 |
| Last Update Date | 2017-08-10 |