| NPI | 1063424752 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTEL MARIE FORSTALL Administrator 678-817-7338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251J00000X Nursing Care (Licence: GA 056-R-0260) |
| Additional Taxonomies | 251E00000X Home Health (Licence: GA 056-R-0260) |
| Enumeration Date | 2006-08-12 |
| Last Update Date | 2020-08-22 |