| NPI | 1902174345 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DERRICK E KIMBLE CEO 706-495-2351 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC005188) |
| Additional Taxonomies | 251J00000X Nursing Care (Licence: GA RN107823) |
| Enumeration Date | 2011-12-13 |
| Last Update Date | 2011-12-13 |