| NPI | 1306487194 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOANNE RAPHAEL Provider 404-291-9181 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2019-10-02 |
| Last Update Date | 2019-10-02 |