| NPI | 1326296856 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE ENNIS MCGEE Manager 678-445-4833 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: IL A-0538-0019-A) |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: IL A-0538-0019-A) |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2008-09-09 |
| Last Update Date | 2021-12-16 |