| NPI | 1083362149 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONDI NICHOLE LITTLE Office Coordinator 912-500-9207 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-03-16 |
| Last Update Date | 2023-07-12 |