| NPI | 1184174302 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANILYN GRAHAM Owner 706-464-6805 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC008002) |
| Enumeration Date | 2016-10-12 |
| Last Update Date | 2016-10-12 |