| NPI | 1447716733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MALCOM NYA Owner 404-934-6513 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2023-05-31 |