| NPI | 1851694590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAVID WILLIAM KUGLIN Owner 770-722-8156 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 916) |
| Enumeration Date | 2010-12-20 |
| Last Update Date | 2010-12-20 |