| NPI | 1619315694 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LILIETH VERINICA PERRY Administrator 770-655-8360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2013-06-12 |
| Last Update Date | 2013-06-12 |