| NPI | 1174014492 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMANDA LEDBETTER Billing Manager 678-209-2355 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-05-22 |
| Last Update Date | 2018-05-22 |