| NPI | 1588140859 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACY DWYER Owner 678-973-7358 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2018-07-19 |
| Last Update Date | 2025-03-13 |