| NPI | 1235511437 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVIA KROW Owner 404-610-1434 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X (Licence: GA LPC008185) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: GA LPC008185) |
| 261QM0850X Clinic/Center, Adult Mental Health (Licence: GA LPC008185) | |
| Enumeration Date | 2015-06-24 |
| Last Update Date | 2015-06-24 |