| NPI | 1497014450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DOROTHY EBERHART Sole Member 770-367-4090 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA CSW003039) |
| Enumeration Date | 2012-05-11 |
| Last Update Date | 2012-05-11 |