| NPI | 1609993526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FLETCHER MCCLELLAND Owner 706-353-8188 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: GA 2465) |
| Enumeration Date | 2007-03-24 |
| Last Update Date | 2020-08-22 |