| NPI | 1811147309 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STEVEN ROCHE Administrator 404-403-1253 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor Mental Health |
| Additional Taxonomies | 2084P0800X Psychiatry & Neurology Psychiatry |
| 2084P0804X Psychiatry & Neurology Child & Adolescent Psychiatry | |
| Enumeration Date | 2008-09-22 |
| Last Update Date | 2013-08-23 |