| NPI | 1710341011 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLETTE CHAIN CULBREATH Owner 678-933-6526 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC008852) |
| Enumeration Date | 2016-04-12 |
| Last Update Date | 2016-04-12 |