| NPI | 1598928111 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LOUETTA CODY Manager, Provider Enrollment 404-785-7876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2008-07-03 |
| Last Update Date | 2023-03-28 |