| NPI | 1972677284 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN BUTLER Billing Manager 706-542-9700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2008-02-12 |