| NPI | 1942711080 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LANCE MICHAEL HENSON CEO 706-969-3569 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional (Licence: GA LPC005156) |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health (Licence: GA LPC005156) |
| Enumeration Date | 2017-10-16 |
| Last Update Date | 2017-10-16 |