| NPI | 1073053641 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KIMBERLY NICOLE LOCKLIN CEO 770-207-7702 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101Y00000X Counselor |
| 252Y00000X Early Intervention Provider Agency | |
| 101YM0800X Counselor, Mental Health | |
| 101YP2500X Counselor, Professional | |
| 103TC0700X Psychologist, Clinical | |
| 104100000X Social Worker | |
| 251B00000X Case Management | |
| 251J00000X Nursing Care | |
| 251S00000X | |
| 253Z00000X In Home Supportive Care | |
| 261Q00000X Clinic/Center | |
| 261QC1500X Clinic/Center, Community Health | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2017-03-02 |
| Last Update Date | 2017-10-12 |