| NPI | 1760853576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNETTA COLLINS Counselor 678-571-0937 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC008575) |
| Enumeration Date | 2015-10-20 |
| Last Update Date | 2015-10-20 |