| NPI | 1104254598 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSEPH MASON Business Manager 706-548-8697 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker Clinical (Licence: GA CSW002536) |
| Enumeration Date | 2013-10-22 |
| Last Update Date | 2013-10-22 |