| NPI | 1518644459 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TREMEZE JACKSON CEO/Nurse Practitioner 770-405-9855 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0850X Clinic/Center Adult Mental Health |
| Additional Taxonomies | 101YA0400X Counselor Addiction (Substance Use Disorder) |
| 101YM0800X Counselor Mental Health | |
| 163WP0808X Registered Nurse Psychiatric/Mental Health | |
| 207Q00000X Family Medicine | |
| 2084P0800X Psychiatry & Neurology Psychiatry | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2023-07-03 |
| Last Update Date | 2023-07-03 |