| NPI | 1295531457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOAN BOURNE CEO/Provider 770-284-6472 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 363LP0808X Nurse Practitioner, Psych/Mental Health |
| Enumeration Date | 2025-02-19 |
| Last Update Date | 2025-06-04 |