| NPI | 1386292514 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAHIYAH MALIKA SHABAZZ CEO 912-656-8402 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| Enumeration Date | 2019-08-30 |
| Last Update Date | 2020-01-08 |