| NPI | 1417580002 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHENA MANNING CEO 770-609-0357 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 251S00000X |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2020-02-21 |
| Last Update Date | 2020-02-21 |