| 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 | 261QM0801X |
| 261QE0002X Clinic/Center, Emergency Care | |
| Enumeration Date | 2017-03-16 |
| Last Update Date | 2017-03-16 |