| NPI | 1386059251 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEREMY B HERTZA Exec Clinical Director 706-823-5266 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health (Licence: GA APC004405) |
| Enumeration Date | 2014-06-30 |
| Last Update Date | 2015-12-04 |