| NPI | 1609359397 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATISHA TUCKER Owner 404-271-0282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2018-09-10 |
| Last Update Date | 2018-09-10 |