| NPI | 1447916713 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TONYA L. EDMOND Owner 470-301-5254 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-11-11 |
| Last Update Date | 2021-11-11 |