| NPI | 1740067065 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ALEX KYLE ALLEN Clinical Director 678-921-9969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2023-09-11 |
| Last Update Date | 2025-07-10 |