NPI | 1902440415 |
---|---|
Entity Type | Organization |
Authorized Contact | AMY RIPLEY Owner 706-351-0783 |
Organization Subpart ? | No |
Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health |
Additional Taxonomies | 101YM0800X Counselor Mental Health |
1041C0700X Social Worker Clinical | |
261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) | |
Enumeration Date | 2019-10-29 |
Last Update Date | 2019-10-29 |