| NPI | 1285961466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ITA GILBERT DORE Clinical Director 770-928-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA 2347) |
| Enumeration Date | 2009-11-10 |
| Last Update Date | 2009-11-10 |