| NPI | 1194179861 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEILA D HAMILTON-BYNUM Executive Director 404-358-0443 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305S00000X Point of Service (Licence: GA 08697) |
| Enumeration Date | 2016-04-19 |
| Last Update Date | 2016-04-19 |