| NPI | 1255162459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KADISON OWENS Therapist/Counselor 678-347-5944 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-08-09 |
| Last Update Date | 2025-06-26 |