NPI | 1972791853 |
---|---|
Entity Type | Organization |
Authorized Contact | THERESA MASEK Lpc 678-378-3226 |
Organization Subpart ? | No |
Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA LPC002436) |
Enumeration Date | 2007-10-04 |
Last Update Date | 2007-10-04 |