| NPI | 1790988475 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KENNETH CHRISTOPHER HAIDER-BARDILL Clinical Director 404-541-2223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: GA LCSW688) |
| Enumeration Date | 2007-06-08 |
| Last Update Date | 2024-06-18 |