| NPI | 1376019141 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MYRNA THURMOND MALONE Clinical Director 770-468-7100 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP1600X Counselor, Pastoral |
| Additional Taxonomies | 103TP2701X Psychologist, Group Psychotherapy |
| 106H00000X Marriage & Family Therapist | |
| 251S00000X | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2018-10-19 |
| Last Update Date | 2018-10-19 |