| NPI | 1235305137 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LASONDA GIBBS ROOKS Lpn 912-367-4614 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 261qm0850x) |
| Enumeration Date | 2008-05-01 |
| Last Update Date | 2008-05-01 |