| NPI | 1356889166 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RHONDA J WILSON Clinical Therapist 678-651-7424 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251B00000X Case Management (Licence: GA 258888) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: GA 258888) |
| Enumeration Date | 2017-02-01 |
| Last Update Date | 2017-02-01 |