| NPI | 1629727573 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSANDRA JOHNSON-LANDRY CEO 678-860-3621 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2022-03-19 |
| Last Update Date | 2022-03-21 |