| NPI | 1417753906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JORDAN LAMONT COSTEN-SUMPTER Owner 404-987-3768 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2025-02-24 |
| Last Update Date | 2025-02-24 |