| NPI | 1386266088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMIKO HORNE Lpc 478-304-4878 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2020-05-15 |
| Last Update Date | 2020-05-15 |