| NPI | 1427769405 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VONITA ISIDORE Cna 678-372-3119 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP0905X Clinic/Center Public Health, State or Local |
| Additional Taxonomies | 252Y00000X Early Intervention Provider Agency |
| Enumeration Date | 2022-12-09 |
| Last Update Date | 2025-02-20 |