| NPI | 1992994172 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GAYLE R ANDRUS Organizer 770-638-3222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 003045) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2007-10-23 |