| NPI | 1811264088 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELE DENISE GREEN CEO/Owner 404-913-9114 |
| Organization Subpart ? | No |
| Primary Taxonomy | 302R00000X Health Maintenance Organization |
| Additional Taxonomies | 251C00000X |
| 251S00000X Community/Behavioral Health | |
| 305R00000X Preferred Provider Organization | |
| 305S00000X Point of Service | |
| Enumeration Date | 2011-11-16 |
| Last Update Date | 2021-03-05 |