| NPI | 1245821966 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRETT ARIC NELSON Medical Director 404-620-9745 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Additional Taxonomies | 261Q00000X Clinic/Center |
| Enumeration Date | 2021-01-27 |
| Last Update Date | 2021-12-22 |