| NPI | 1891301529 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RAVEN HARRIS Owner 678-478-6268 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Enumeration Date | 2020-09-18 |
| Last Update Date | 2020-09-18 |