| NPI | 1194362699 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAHEERAH DEMBY CEO 470-207-1866 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| Enumeration Date | 2019-12-03 |
| Last Update Date | 2020-07-13 |