| NPI | 1467645044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DANNETTA B SPARKS CEO/Director 770-981-2903 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 113193193A) |
| Enumeration Date | 2007-08-27 |
| Last Update Date | 2007-08-27 |