| NPI | 1770788135 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SYLVIA SCHYBERG Director 706-761-8463 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: CO 1262) |
| Additional Taxonomies | 251S00000X (Licence: AL LCSW, PIP) |
| 251S00000X (Licence: GA 003844) | |
| Enumeration Date | 2007-06-17 |
| Last Update Date | 2009-04-24 |