| NPI | 1962174961 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KELLY RENEE LOVE Executive Admin 404-382-8581 |
| Organization Subpart ? | No |
| Primary Taxonomy | 101YA0400X Counselor, Addiction (Substance Use Disorder) |
| Additional Taxonomies | 103TA0400X Psychologist, Addiction (Substance Use Disorder) |
| 163WA0400X Registered Nurse, Addiction (Substance Use Disorder) | |
| Enumeration Date | 2021-09-29 |
| Last Update Date | 2021-09-29 |