| NPI | 1376953364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HARRIS TODD POPE Owner/Operator 678-447-4289 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 163WP0807X Registered Nurse Psychiatric/Mental Health, Child & Adolescent | |
| Enumeration Date | 2014-04-30 |
| Last Update Date | 2014-04-30 |