| NPI | 1114423829 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER HOLLINGSWORTH Owner 678-948-6003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: GA LPC006594) |
| Enumeration Date | 2018-04-02 |
| Last Update Date | 2018-04-02 |