| NPI | 1639792849 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CYNTHA FEDRICK COO 404-376-8512 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 251V00000X Voluntary or Charitable |
| Enumeration Date | 2020-05-21 |
| Last Update Date | 2020-05-21 |