| NPI | 1437683315 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JACK COTTOM Owner 404-918-6042 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: PA PC009399) |
| Enumeration Date | 2017-04-17 |
| Last Update Date | 2017-04-17 |