| NPI | 1891050464 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTOPHER STEWART CEO 706-536-1360 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC004892) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health (Licence: GA 19402) |
| Enumeration Date | 2012-07-10 |
| Last Update Date | 2012-07-10 |