| NPI | 1104550847 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTOR T GRIMES Owner 678-755-7160 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X | |
| Enumeration Date | 2022-07-09 |
| Last Update Date | 2023-10-26 |