| NPI | 1134640451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH MORAN CFO 478-275-6811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-06-28 |
| Last Update Date | 2017-06-28 |