| NPI | 1457805467 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHN HAIGLER Administration 912-434-1794 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: GA 74308) |
| Additional Taxonomies | 261QM2800X Clinic/Center, Methadone Clinic |
| Enumeration Date | 2016-08-08 |
| Last Update Date | 2023-01-05 |