| NPI | 1760834972 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LAUREN WALTHER Member 404-444-4555 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: TX 55788) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2016-07-12 |