| NPI | 1710640883 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRISTIAN O DUARTE Chief Operational Officer 678-382-7915 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-10-15 |
| Last Update Date | 2021-11-01 |