| NPI | 1972625465 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEN WARNER Administrator 770-458-1594 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2084P0800X Psychiatry & Neurology, Psychiatry (Licence: GA 28337) |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2020-08-22 |