| NPI | 1104569045 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAITLIN LAWRENCE Owner 678-699-8558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101Y00000X Counselor |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2022-04-19 |
| Last Update Date | 2022-04-19 |