| NPI | 1285913236 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENDOLYN SMITH Consultant 678-245-9747 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: GA RPH024484) |
| Additional Taxonomies | 251V00000X Voluntary or Charitable (Licence: GA RPH024484) |
| Enumeration Date | 2011-08-09 |
| Last Update Date | 2011-08-09 |