| NPI | 1164731576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA ANN CLARK-BECKFORD Ddp/Admin. 770-865-1003 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 067-01-434-1) |
| Enumeration Date | 2010-10-03 |
| Last Update Date | 2018-03-30 |