| NPI | 1134361512 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RANCE WILLIAM HUMPHREYS President 706-529-9614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 046427) |
| Enumeration Date | 2009-03-31 |
| Last Update Date | 2009-03-31 |