| NPI | 1992380836 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ARDRIA L CLARK Executive Director 229-403-7047 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QH0100X Clinic/Center, Health Services |
| Additional Taxonomies | 101Y00000X Counselor |
| 101YP2500X Counselor, Professional | |
| Enumeration Date | 2021-03-12 |
| Last Update Date | 2021-03-12 |