| NPI | 1568625457 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EASTLYN ELOISE HARDING-MARIN Medical Director 678-625-5431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services (Licence: GA 056841) |
| Enumeration Date | 2008-07-09 |
| Last Update Date | 2008-07-09 |