| NPI | 1821522947 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHAKAYLA WARE Owner 912-225-3454 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC009193) |
| Enumeration Date | 2017-04-14 |
| Last Update Date | 2017-04-14 |