| NPI | 1780880146 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEBORAH H. LOFTISS Qa Director 229-226-4634 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA C10000012033) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2020-08-22 |