| NPI | 1942870290 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRIAN MICHAEL ROBERTS CEO 706-514-6341 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YP2500X Counselor, Professional |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 1041C0700X Social Worker, Clinical | |
| Enumeration Date | 2021-06-29 |
| Last Update Date | 2022-05-11 |