| NPI | 1811607336 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHATARA JACKSON CEO/Owner 912-507-0326 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 261QM0850X Clinic/Center, Adult Mental Health | |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2022-11-28 |
| Last Update Date | 2023-03-24 |