| NPI | 1952858557 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | AMELIA DERAMUS Associate Counselor 678-227-2593 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) (Licence: GA APC005565) |
| Enumeration Date | 2016-09-01 |
| Last Update Date | 2021-06-30 |