| NPI | 1093963720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK WATERS State Director 706-736-8170 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2008-09-06 |
| Last Update Date | 2021-05-14 |