| NPI | 1457876906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMY FOWLER JAYNES Owner/Clinical Director 770-451-0404 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-08-06 |
| Last Update Date | 2022-07-21 |