| NPI | 1801332150 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYEAST REYNOLDS Director Of Rcm 678-813-0428 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder (Licence: GA 033-421-D) |
| Enumeration Date | 2017-01-10 |
| Last Update Date | 2019-04-11 |