| NPI | 1770731499 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICK WATERS State Director 706-200-8677 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 104100000X Social Worker |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2008-09-06 |
| Last Update Date | 2021-04-19 |