| NPI | 1245472281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN TUCKER Billing Manager 678-513-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC005387) |
| Enumeration Date | 2009-04-06 |
| Last Update Date | 2009-04-06 |