| NPI | 1508632720 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEITH FREDERICK SMITH CEO 678-469-6843 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 104100000X Social Worker | |
| 1041C0700X Social Worker, Clinical | |
| 177F00000X Lodging | |
| 251E00000X Home Health | |
| 261Q00000X Clinic/Center | |
| 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2023-11-29 |
| Last Update Date | 2023-11-29 |