| NPI | 1952841306 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CRISTA ENGELSON Owner 678-252-8087 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA MFT001423) |
| Enumeration Date | 2017-03-05 |
| Last Update Date | 2017-03-05 |