| NPI | 1831348119 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WAKEITHA VAIL Billing Specialist 912-658-1149 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101YM0800X Counselor, Mental Health |
| Additional Taxonomies | 104100000X Social Worker |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2019-01-04 |