| NPI | 1881461069 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | COURTNEY E FIELDS Owner/Operator 706-389-0585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2023-12-07 |
| Last Update Date | 2023-12-07 |