| NPI | 1952661415 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELANA A WINFREY Owner 678-228-8643 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC003650) |
| Enumeration Date | 2012-05-17 |
| Last Update Date | 2013-07-04 |