| NPI | 1588062418 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRY N. VEAL Administrator 706-559-0059 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: GA applied for) |
| Enumeration Date | 2014-12-09 |
| Last Update Date | 2014-12-09 |