| NPI | 1619326584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERA LYNN IRVINE Therapist 478-361-2875 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC3186) |
| Enumeration Date | 2016-06-10 |
| Last Update Date | 2016-06-20 |