| NPI | 1609370212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMEKA YASCHE MACK CEO/ Clinical Director 478-254-0481 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: GA 101YP2500X) |
| Enumeration Date | 2018-03-19 |
| Last Update Date | 2020-05-22 |