| NPI | 1720110398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NASIRA RUBINA President 678-749-6063 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: GA 056642) |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health (Licence: GA 056642) |
| Enumeration Date | 2007-03-09 |
| Last Update Date | 2012-06-06 |