| NPI | 1083901722 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICE COX Owner/Counselor 678-604-7020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC005841) |
| Enumeration Date | 2011-07-01 |
| Last Update Date | 2017-05-08 |