| NPI | 1891217824 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JULIE KECK Owner 706-414-6811 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC009005) |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2017-07-12 |
| Last Update Date | 2025-06-16 |