| NPI | 1669974887 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANDY MICHELLE MILLER COO 912-200-7608 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: GA CSW004354) |
| Additional Taxonomies | 261QM0850X Clinic/Center Adult Mental Health |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| Enumeration Date | 2018-03-03 |
| Last Update Date | 2018-03-03 |