| NPI | 1689033060 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAWN M. JETT Owner 706-951-2182 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA csw003221) |
| Enumeration Date | 2016-02-15 |
| Last Update Date | 2024-01-26 |