| NPI | 1982840245 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDRINA JORDAN Owner/Director 678-744-5603 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: MI 6401009892) |
| Enumeration Date | 2008-12-16 |
| Last Update Date | 2019-09-25 |