| NPI | 1841956364 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FORREST RICHARDSON COO 470-295-3152 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QR0405X Clinic/Center Rehabilitation, Substance Use Disorder |
| Enumeration Date | 2021-11-09 |
| Last Update Date | 2021-11-19 |