| NPI | 1639936180 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEPHEN D ROGERS Owner 706-331-2892 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0801X |
| Enumeration Date | 2024-03-01 |
| Last Update Date | 2024-03-01 |