| NPI | 1346472081 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY M STEVENS Owner 770-509-1034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC004201) |
| Enumeration Date | 2009-08-13 |
| Last Update Date | 2009-08-13 |