| NPI | 1497402093 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VANESSA ANTIONETTE MACK Paraprofessional 678-822-6058 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2022-03-04 |
| Last Update Date | 2022-03-04 |