| NPI | 1093963944 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE RAE MCCONNELL Administrator 770-775-9044 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: GA NTP-001027) |
| Enumeration Date | 2008-09-04 |
| Last Update Date | 2008-09-04 |