| NPI | 1699201756 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARAJEAN GRAY Owner 912-506-1163 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA CSW006049) |
| Enumeration Date | 2017-05-11 |
| Last Update Date | 2017-05-11 |