| NPI | 1518485143 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TANYA ELLIS-ASBURY Owner 706-250-0613 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2017-09-04 |
| Last Update Date | 2024-09-15 |