| NPI | 1598043580 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA SUNBURY WOOD Owner 912-262-1112 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA CSW003677) |
| Enumeration Date | 2011-07-26 |
| Last Update Date | 2011-07-26 |