| NPI | 1538609888 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RJ LEWIS Executive Director 770-319-7468 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| Enumeration Date | 2017-03-06 |
| Last Update Date | 2017-03-06 |