| NPI | 1518485044 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TARA M WOODARD Vice President 678-334-9650 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2017-09-05 |
| Last Update Date | 2017-09-05 |