| NPI | 1013219450 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EVELYN JOHNSON Owner 770-987-0390 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: GA 044014111) |
| Enumeration Date | 2010-11-17 |
| Last Update Date | 2010-11-17 |