| NPI | 1265817530 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALVIN C SUTHERLAND Owner 770-853-6372 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC004159) |
| Enumeration Date | 2015-07-28 |
| Last Update Date | 2015-07-28 |