| NPI | 1508470428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHENA F LOCKE CEO 404-783-8135 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 261QC1800X |
| 261QH0100X Clinic/Center, Health Services | |
| 305R00000X Preferred Provider Organization | |
| Enumeration Date | 2020-09-08 |
| Last Update Date | 2020-09-08 |