| NPI | 1316270085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JADA A. TIDWELL Owner 404-797-0889 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2009-09-14 |
| Last Update Date | 2009-09-14 |