| NPI | 1154007540 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | KAYLA MAZZONI Counselor 912-631-7241  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | 
| Enumeration Date | 2023-06-22 | 
| Last Update Date | 2023-06-22 |