| NPI | 1770089153 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAMIKA ALFORD Owner 678-296-7861 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC009555) |
| Enumeration Date | 2018-04-04 |
| Last Update Date | 2018-04-04 |