| NPI | 1194197244 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNEITH DURDEN CEO 912-988-3649 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2015-10-28 |
| Last Update Date | 2015-10-28 |