NPI | 1861895450 |
---|---|
Entity Type | Organization |
Authorized Contact | TYEAST REYNOLDS Director Rcm 678-813-0428 |
Organization Subpart ? | Yes |
Primary Taxonomy | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
101YM0800X Counselor, Mental Health | |
103T00000X Psychologist | |
103TP2701X Psychologist, Group Psychotherapy | |
Enumeration Date | 2014-09-26 |
Last Update Date | 2019-04-11 |