| NPI | 1639855539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE FOLSOM Clinical COO Rdinator 229-891-7300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center Developmental Disabilities |
| Enumeration Date | 2023-06-26 |
| Last Update Date | 2023-06-26 |