| NPI | 1275686198 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JON C. RUBENOW Medical Director 678-513-5707 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder (Licence: GA 0591) |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2020-08-22 |