| NPI | 1124416169 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LISA ELAINE MOORE BRANDON Certified Peer Support Specialist 984-232-8073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2014-12-29 |
| Last Update Date | 2014-12-29 |