| NPI | 1104563469 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA WILLIAMS Administrator 770-885-2884 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2022-05-18 |
| Last Update Date | 2022-05-18 |