| NPI | 1831511823 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | UDANA THOMAS Admin 678-789-8546 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0802X Psychiatry & Neurology, Addiction Psychiatry |
| Additional Taxonomies | 1041C0700X Social Worker, Clinical |
| 101Y00000X Counselor | |
| 101YA0400X Counselor, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2014-01-10 |
| Last Update Date | 2022-06-13 |