| NPI | 1174862908 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | INDIA C JOHNSON Co Owner 770-474-4009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center Methadone (Licence: GA NTP001062) |
| Enumeration Date | 2013-02-14 |
| Last Update Date | 2013-02-14 |