| NPI | 1326683517 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE WARE SPENCER Owner 678-404-1077 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-11-12 |
| Last Update Date | 2021-12-20 |