| NPI | 1215392535 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DIANE BRANTLEY Executive Director 706-310-9046 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA APC005174) |
| Enumeration Date | 2015-12-31 |
| Last Update Date | 2015-12-31 |