| NPI | 1124253679 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHET ALLEN FOWLER Executive Director 770-554-3599 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC005585) |
| Enumeration Date | 2009-05-27 |
| Last Update Date | 2009-05-27 |