| NPI | 1285248773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARRY SCOTT GORDON President 678-558-3930 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-09-02 |
| Last Update Date | 2020-09-02 |