| NPI | 1356405773 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RJICHARD EDWARD GRANT Physician 404-467-7670 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 044472) |
| Enumeration Date | 2006-12-20 |
| Last Update Date | 2020-08-22 |