| NPI | 1316239247 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER ANN KIMMERLE Owner/Provider 678-787-6721 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: GA MFT001141) |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2011-05-11 |