| NPI | 1225338577 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AGNEAU JEAN-SIMON Staff 770-865-5073 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 932102913) |
| Enumeration Date | 2010-11-02 |
| Last Update Date | 2024-03-14 |