| NPI | 1174891774 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LESLIE S BACKUS CFO 912-355-1440 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 025-698-D) |
| Enumeration Date | 2011-12-09 |
| Last Update Date | 2011-12-09 |