| NPI | 1750785804 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHERRELL D THOMAS Sole Proprietor 404-409-1891 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) (Licence: GA 005987) |
| Enumeration Date | 2014-10-17 |
| Last Update Date | 2014-10-17 |