| NPI | 1053730267 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRACIE MICHELLE HOOKS Owner 478-390-1264 |
| Organization Subpart ? | No |
| Primary Taxonomy | 3104A0625X Assisted Living Facility, Assisted Living, Mental Illness (Licence: GA 3104A065X) |
| Enumeration Date | 2014-04-15 |
| Last Update Date | 2014-04-15 |