| NPI | 1811346265 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATONYA COWAN PATTERSON Owner 706-399-6284 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC005565) |
| Enumeration Date | 2016-06-07 |
| Last Update Date | 2016-06-07 |