| NPI | 1811380843 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARLENE HAUGHTON Owner 678-371-2251 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 107-R-1199) |
| Enumeration Date | 2015-03-16 |
| Last Update Date | 2015-03-16 |