| NPI | 1245694702 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROBIN E DOCK Sole Proprietor/Owner 678-614-3211 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: NC S9895) |
| Enumeration Date | 2016-04-11 |
| Last Update Date | 2016-04-11 |