| NPI | 1689939076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PAULINE HENRY Owner 706-587-8986 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 108544) |
| Enumeration Date | 2012-07-11 |
| Last Update Date | 2012-07-11 |