| NPI | 1407357270 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CONNIE J YOUNG-GIBRALTARIK Owner 678-430-2921 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC009420) |
| Enumeration Date | 2018-02-26 |
| Last Update Date | 2018-02-26 |