| NPI | 1073356986 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MONTRELL ROSS Owner 706-333-2151 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2024-06-18 |
| Last Update Date | 2024-06-18 |