| NPI | 1215358015 |
|---|---|
| Other Name | LIVING FULLY |
| Entity Type | Organization |
| Authorized Contact | PEGAH MOGHADDAM Owner/Director 678-591-9117 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: GA PSY003405) |
| Enumeration Date | 2013-12-20 |
| Last Update Date | 2013-12-20 |