| NPI | 1487020384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZANETA WILLIS Owner 478-320-8014 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC007903) |
| Enumeration Date | 2015-08-13 |
| Last Update Date | 2015-08-13 |