| NPI | 1184167637 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PALENENA M MCMANUS Licensed Therapist 678-557-2676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization (Licence: GA LPC006907) |
| Enumeration Date | 2016-11-30 |
| Last Update Date | 2016-11-30 |