| NPI | 1104273234 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKKI WRIGHT Owner 678-834-7615 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 251S00000X | |
| 305S00000X Point of Service | |
| Enumeration Date | 2016-05-18 |
| Last Update Date | 2016-05-18 |