| NPI | 1023339918 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEVIN MONIX CEO 770-771-1559 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: GA 044017532) |
| Enumeration Date | 2010-06-15 |
| Last Update Date | 2010-06-15 |