| NPI | 1487734372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE A HOLSTAD Owner 770-513-8988 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) (Licence: GA LPC002598) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC002598) |
| 101YP2500X Counselor, Professional (Licence: GA LPC002598) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2020-08-22 |