| NPI | 1174969687 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONALD CRAIG MCLEAN Medical Director 478-302-5106 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA 030163) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2022-06-23 |