NPI | 1730622564 |
---|---|
Entity Type | Organization |
Authorized Contact | URSULA MICHELLE DAVIS Owner 678-862-3383 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: GA LPC006950) |
Enumeration Date | 2016-11-28 |
Last Update Date | 2016-11-28 |