| NPI | 1710384086 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELODY A THOMPSON Owner 678-637-8643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC005646) |
| Enumeration Date | 2014-12-02 |
| Last Update Date | 2014-12-02 |