| NPI | 1518487404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERRI VERNESE JENKINS Executive Director 706-496-1010 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: GA LPC006595) |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: GA LPC006595) |
| 261QM0850X Clinic/Center Adult Mental Health (Licence: GA LPC006595) | |
| Enumeration Date | 2017-06-22 |
| Last Update Date | 2017-06-22 |