| NPI | 1699239475 |
|---|---|
| Doing Business As | GEORGIA BEHAVIORAL HEALTH PRACTITIONER CLINIC |
| Entity Type | Organization |
| Authorized Contact | LOUISE WISE Provider 678-831-6429 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2019-01-26 |
| Last Update Date | 2023-04-09 |