| NPI | 1447670518 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEMETRIA ANN BOLAR Managing Partner 678-948-7476 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA lpc007280) |
| Additional Taxonomies | 251B00000X Case Management (Licence: GA lpc007280) |
| Enumeration Date | 2014-04-16 |
| Last Update Date | 2014-04-16 |