| NPI | 1316373269 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBBY VANDERBUNT Office Manager 770-786-8598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA APC002637) |
| Enumeration Date | 2013-09-24 |
| Last Update Date | 2013-09-24 |