| NPI | 1962968222 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL HALL Medical Director 912-927-6832 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 251S00000X Community/Behavioral Health |
| 261QI0500X Clinic/Center, Infusion Therapy | |
| 261QR0800X Clinic/Center, Recovery Care | |
| Enumeration Date | 2019-02-12 |
| Last Update Date | 2019-04-18 |