| NPI | 1710385372 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAKEISHA MARIE VARNER Owner 770-765-3252 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC006967) |
| Additional Taxonomies | 251K00000X Public Health or Welfare (Licence: GA LPC006967) |
| Enumeration Date | 2014-12-15 |
| Last Update Date | 2014-12-15 |