| NPI | 1710218466 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN KEELAGHAN Program Sponsor 770-248-1616 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM2800X Clinic/Center, Methadone Clinic (Licence: GA NTP001037) |
| Enumeration Date | 2010-01-20 |
| Last Update Date | 2024-02-23 |