| NPI | 1417700972 |
|---|---|
| Other Name | M-PACK |
| Entity Type | Organization |
| Authorized Contact | DEMARCUS DEVON COPELANND Founder And Program Director 678-849-4656 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 252Y00000X Early Intervention Provider Agency | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2024-04-05 |
| Last Update Date | 2024-04-05 |