| NPI | 1831724384 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY KING MOORE Lpc 470-433-5048 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| Enumeration Date | 2020-03-05 |
| Last Update Date | 2020-08-05 |