| NPI | 1447695085 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHANIE FLETCHER CFO 229-236-0831 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry |
| Additional Taxonomies | 261Q00000X Clinic/Center (Licence: GA 59451) |
| 261QP2300X Clinic/Center, Primary Care (Licence: GA 59451) | |
| Enumeration Date | 2013-05-09 |
| Last Update Date | 2022-05-13 |