| NPI | 1992397590 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEENA PATEL Director 706-372-2428 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM0801X Clinic/Center Mental Health (Including Community Mental Health Center) |
| Enumeration Date | 2021-02-05 |
| Last Update Date | 2021-02-05 |