| NPI | 1770343584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMBER BLACKLOCK Director Of Finance 678-769-6594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2024-03-20 |
| Last Update Date | 2024-03-20 |