| NPI | 1861972952 |
|---|---|
| Former Legal Business Name | DOG HOUSE ATL GLBT RECOVERY INC |
| Entity Type | Organization |
| Authorized Contact | J.D. WEIDNER CEO 404-769-1118 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor Professional (Licence: GA LPC009051) |
| Enumeration Date | 2018-08-17 |
| Last Update Date | 2018-08-17 |