| 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 |