| NPI | 1922531938 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NIKIA SCOTT Owner 770-800-6498 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0855X Clinic/Center Adolescent and Children Mental Health (Licence: GA 17-45799) |
| Enumeration Date | 2017-04-06 |
| Last Update Date | 2023-05-30 |