| NPI | 1992162564 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LA TONYA RASHELL DANIEL Recovery Services Supervisor 706-428-4150 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2016-01-27 |
| Last Update Date | 2016-01-27 |