| NPI | 1356693279 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDY MYRICK Office Manager 912-489-8787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: GA PSY0011702) |
| Enumeration Date | 2012-10-03 |
| Last Update Date | 2012-10-03 |