| NPI | 1780759928 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FAYE CRAWFORD Office Manager 706-364-3209 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0850X Clinic/Center, Adult Mental Health (Licence: GA CSW2404) |
| Additional Taxonomies | 261QM0855X Clinic/Center, Adolescent and Children Mental Health (Licence: GA 043774) |
| Enumeration Date | 2006-11-22 |
| Last Update Date | 2008-05-22 |