| NPI | 1578994026 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES KEITH FRICKS Therapist 706-252-1223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC006020) |
| Enumeration Date | 2013-12-10 |
| Last Update Date | 2013-12-10 |