| NPI | 1699104281 |
|---|---|
| Former Legal Business Name | N/A |
| Entity Type | Organization |
| Authorized Contact | NIKKI KWONA RICHARDSON CEO 678-778-9091 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2013-11-05 |
| Last Update Date | 2013-11-05 |