| NPI | 1134560840 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SARAH PRESIDENT Administrator/Manager 770-616-7758 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA CLA000784) |
| Enumeration Date | 2013-07-10 |
| Last Update Date | 2013-07-10 |