| NPI | 1760892574 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MORA SPICER Program Director 404-720-4056 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: IL 69251749) |
| Enumeration Date | 2014-05-01 |
| Last Update Date | 2014-05-01 |