| NPI | 1750619789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE PALMER Owner 478-319-0367 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC005494) |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2009-12-02 |