| NPI | 1548693039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA JANE RAMIREZ Owner 229-834-5986 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC006409) |
| Enumeration Date | 2013-08-20 |
| Last Update Date | 2021-06-30 |