| NPI | 1467858423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MIKE FARMER CEO 912-201-3605 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor Addiction (Substance Use Disorder) (Licence: GA 025-277-D) |
| Additional Taxonomies | 101Y00000X Counselor (Licence: GA 025-277-D) |
| Enumeration Date | 2014-11-18 |
| Last Update Date | 2014-11-18 |