| NPI | 1215260666 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALETHA JENNIFER CLARK Owner 404-550-0564 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA 004805) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA 1658-R) |
| Enumeration Date | 2009-09-16 |
| Last Update Date | 2024-02-23 |