| NPI | 1225402639 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SADAQA WARD Clinical Social Worker 678-613-0430 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: GA CSW004266) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: GA CSW004266) |
| Enumeration Date | 2015-11-23 |
| Last Update Date | 2016-01-06 |