| NPI | 1205352093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AYJANAH RASHEEDA MOORE Nurse Practitioner 404-944-1174 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: GA APRN207446) |
| Enumeration Date | 2017-08-14 |
| Last Update Date | 2017-08-14 |