| NPI | 1457074403 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DONTE RANDALL Owner/ Substance Abuse Counselor 678-488-9563 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 101YM0800X Counselor Mental Health |
| 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2022-09-23 |
| Last Update Date | 2022-10-10 |