| NPI | 1396199238 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BAKARI E VICKERSON Sole Proprietor 404-423-7215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: GA 066914) |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2016-04-18 |