| NPI | 1700449477 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMARA CONLIN Interim CEO 706-389-6789 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2019-04-18 |