| NPI | 1578122578 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA LEE SAGE Financial Operations Generalist Sup 770-531-4558 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2019-06-12 |
| Last Update Date | 2019-06-12 |