| NPI | 1407673148 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUNIA BAKER Clinical Director 678-658-3699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 1041C0700X Social Worker Clinical | |
| 171400000X | |
| 171M00000X Case Manager/Care Coordinator | |
| Enumeration Date | 2024-09-24 |
| Last Update Date | 2024-09-24 |