| NPI | 1750743076 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINETTE LESLIE-FONDON CEO 706-593-0827 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC003879) |
| Enumeration Date | 2016-03-25 |
| Last Update Date | 2016-03-25 |