| NPI | 1124721089 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INGRID RICHARDSON Owner/Director 678-687-1224 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-03-22 |
| Last Update Date | 2023-03-22 |