| NPI | 1881936623 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RICHARD CHARLES LIE-NIELSEN President 678-760-2704 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC004695) |
| Enumeration Date | 2013-03-20 |
| Last Update Date | 2013-03-20 |