| NPI | 1306674726 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHEREE A WYATT Program Director 678-914-2982 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-07-25 |
| Last Update Date | 2024-07-25 |