| NPI | 1144419748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEISHA H JOHNSON CEO 678-610-4400 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA 004077) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 004077) |
| 101YP2500X Counselor, Professional (Licence: GA 004077) | |
| Enumeration Date | 2007-10-18 |
| Last Update Date | 2011-12-13 |