| NPI | 1093555989 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARMINE COSTELLO President 404-936-2346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-05-29 |
| Last Update Date | 2024-05-29 |