| NPI | 1508563651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JEFF BAUCOM CEO 404-713-4280 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine |
| Additional Taxonomies | 261QH0100X Clinic/Center, Health Services |
| 261QM2500X Clinic/Center, Medical Specialty | |
| 163WP0809X Registered Nurse, Psych/Mental Health, Adult | |
| 2472E0500X Technician, Other, EEG | |
| 251S00000X Community/Behavioral Health | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| Enumeration Date | 2023-02-09 |
| Last Update Date | 2025-09-08 |