| NPI | 1134906118 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN OLIVIA PATTERSON-SIEKIRK Sole Owner 912-231-7279 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-09-12 |
| Last Update Date | 2023-09-12 |