| NPI | 1093323305 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QIANA TOY-ELLIS CEO 706-987-3315 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YA0400X Counselor Addiction (Substance Use Disorder) | |
| 101YP2500X Counselor Professional | |
| 251B00000X Case Management | |
| 251C00000X Day Training, Developmentally Disabled Services | |
| 251S00000X Community/Behavioral Health | |
| 252Y00000X Early Intervention Provider Agency | |
| 253Z00000X In Home Supportive Care | |
| 261QD1600X Clinic/Center Developmental Disabilities | |
| 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) | |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center Adult Mental Health | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder | |
| Enumeration Date | 2020-07-22 |
| Last Update Date | 2021-09-13 |