| NPI | 1982071858 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TIRZAH K BROWN Ged Coach 239-410-2585 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA CCI001962) |
| Enumeration Date | 2015-08-27 |
| Last Update Date | 2015-08-27 |