| NPI | 1104248814 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | L MATT WILSON Managing Member 404-364-2240 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2014-01-15 |
| Last Update Date | 2014-01-15 |