NPI | 1093111049 |
---|---|
Entity Type | Organization |
Authorized Contact | DAMIEN KELLAM President & CEO 678-545-4285 |
Organization Subpart ? | No |
Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC005815) |
Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC005856) |
Enumeration Date | 2014-11-18 |
Last Update Date | 2014-11-18 |