| NPI | 1669089132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA D FREEMAN Nurse Practitioner 770-312-6484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 163WP0000X Registered Nurse, Pain Management |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 324500000X Substance Abuse Rehabilitation Facility | |
| Enumeration Date | 2020-09-28 |
| Last Update Date | 2024-09-10 |