| NPI | 1245508456 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MOHAMMED K SOOMRO Owner 706-494-1460 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: GA 049626) |
| Enumeration Date | 2011-12-02 |
| Last Update Date | 2011-12-19 |