| NPI | 1073968921 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIVANDA VERMELL GREGG MARTIN Owner/ Therapist 770-789-6403 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 005239) |
| Enumeration Date | 2016-04-28 |
| Last Update Date | 2016-04-28 |