| NPI | 1689286130 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELLA MICHELLE STEPHENSON Administrator 470-545-0860 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| 261QM1300X Clinic/Center, Multi-Specialty | |
| 261QM2800X Clinic/Center, Methadone Clinic | |
| Enumeration Date | 2020-08-17 |
| Last Update Date | 2025-08-24 |