| NPI | 1487965281 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LADOLGY S GILL Owner 706-593-0051 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251B00000X Case Management |
| Enumeration Date | 2010-06-25 |
| Last Update Date | 2010-06-25 |