| NPI | 1427788561 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COREY T PRICE Owner 678-709-9021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2022-06-13 |
| Last Update Date | 2022-06-13 |