| NPI | 1083963607 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VELENA MIXON Owner/Director 404-434-6711 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: GA 2012013672) |
| Enumeration Date | 2012-08-29 |
| Last Update Date | 2012-08-29 |