| NPI | 1619515855 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TISA STANLEY Enrollment Specialist 770-284-1787 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2019-12-18 |
| Last Update Date | 2019-12-18 |