| NPI | 1790861995 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA NKOMAZANA Billing Specialist 404-589-9040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QP2300X Clinic/Center Primary Care (Licence: GA 024478) |
| Additional Taxonomies | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-10-31 |
| Last Update Date | 2024-01-03 |