| NPI | 1760157200 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER BARNETT Owner 678-416-1584 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health |
| Enumeration Date | 2021-08-16 |
| Last Update Date | 2021-08-16 |