| NPI | 1669918231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLOS JUSTAVIS FOSTER CEO 706-447-9722 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2017-01-06 |
| Last Update Date | 2024-01-18 |