| NPI | 1669946943 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAMELA DESHAWN JOHNSON Owner 678-570-7752 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 104100000X Social Worker |
| 1041C0700X Social Worker Clinical | |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2019-01-19 |
| Last Update Date | 2024-06-20 |