| NPI | 1497297592 | 
|---|---|
| Entity Type | Organization | 
| Authorized Contact | LISA M JAMISON Social Worker 678-437-6302  | 
| Organization Subpart ? | No | 
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 005038)  | 
| Enumeration Date | 2016-11-07 | 
| Last Update Date | 2017-10-19 |