| NPI | 1225579758 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLIVER J BOOKER CEO 706-389-6789 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities |
| Additional Taxonomies | 261QE0002X Clinic/Center Emergency Care |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2017-03-16 |