| NPI | 1538679642 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERRI VAUGHN COURSEY Organizer 678-304-7176 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC009228) |
| Enumeration Date | 2017-10-03 |
| Last Update Date | 2017-10-03 |