| NPI | 1528696796 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | IMANI NIA JOHNSON Owner 678-612-6699 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 251S00000X | |
| Enumeration Date | 2020-04-01 |
| Last Update Date | 2021-07-01 |