| NPI | 1477385771 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JASON P BENTON Owner 706-549-3606 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2024-08-15 |
| Last Update Date | 2024-08-15 |