| NPI | 1538712088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILDRED WATSON Owner/Director Of Clinical Services 770-203-0842 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2019-07-23 |
| Last Update Date | 2019-07-23 |