| NPI | 1942248539 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OGENE LEWIS DAVIS Clinical Directorproprietor 404-292-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Enumeration Date | 2006-06-03 |
| Last Update Date | 2020-08-22 |