| NPI | 1104014554 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL WAYNE GOLDMAN Lmft/ Coordinator Clarke County 251-275-4165 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: AL L258) |
| Enumeration Date | 2007-10-11 |
| Last Update Date | 2007-10-11 |