| NPI | 1457584054 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAY L GRESHAM Director 706-364-8683 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 002457) |
| Enumeration Date | 2009-08-29 |
| Last Update Date | 2009-08-29 |