| NPI | 1275808487 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES L. GONZALES Owner 770-995-6026 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: GA 1640) |
| Enumeration Date | 2012-03-21 |
| Last Update Date | 2012-03-21 |