| NPI | 1376299388 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DENNIS JONES Owner 678-614-8118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2022-02-28 |
| Last Update Date | 2022-02-28 |