| NPI | 1245696723 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ERLESE M CARUTH Director 678-480-8302 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA LPC006820) |
| Enumeration Date | 2016-01-13 |
| Last Update Date | 2016-01-20 |