| NPI | 1104390038 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JIKEALA TAYLOR Chief Executive Officer 678-515-6507 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-01-14 |
| Last Update Date | 2019-06-14 |