| NPI | 1356999122 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ASHLYN AYRES ELLINGTON Owner 404-863-0646 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-08-26 |
| Last Update Date | 2019-08-26 |