| NPI | 1063881761 |
|---|---|
| Doing Business As | 1802 PENNINGTON |
| Entity Type | Organization |
| Authorized Contact | JENNIFER D LOZANO SVP Financial Services 404-968-2663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities (Licence: TN L000000012140) |
| Enumeration Date | 2015-09-23 |
| Last Update Date | 2024-10-18 |