| NPI | 1902463904 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MILES NEAL CEO 678-674-7311 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 101Y00000X Counselor |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| Enumeration Date | 2019-05-24 |
| Last Update Date | 2019-05-30 |