| NPI | 1417403593 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ANDERSON Owner 478-714-6398 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: AL 31808) |
| Enumeration Date | 2016-08-29 |
| Last Update Date | 2016-08-29 |