| NPI | 1073164315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERICA PARKER Owner 912-572-7585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-09-27 |
| Last Update Date | 2023-03-16 |