| NPI | 1407440100 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTALE SEALS Owner 404-518-2295 |
| Organization Subpart ? | No |
| Primary Taxonomy | 103TB0200X Psychologist, Cognitive & Behavioral |
| Additional Taxonomies | 251B00000X Case Management |
| 251S00000X | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 261QR0800X Clinic/Center, Recovery Care | |
| Enumeration Date | 2021-02-23 |
| Last Update Date | 2022-04-07 |