| NPI | 1124414495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN R MCCULLOUGH Principal 770-256-9921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities (Licence: SC 7626) |
| Enumeration Date | 2015-04-13 |
| Last Update Date | 2015-04-13 |