| NPI | 1790049039 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DICK COTTRILL COO 678-556-0840 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2012-07-02 |
| Last Update Date | 2012-07-02 |