| NPI | 1164111803 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA JANE MADSEN Manager/Owner 404-448-2080 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 101YM0800X Counselor, Mental Health | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| Enumeration Date | 2023-05-08 |
| Last Update Date | 2023-05-08 |