| NPI | 1083982797 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CARLTON S. WATT CEO 404-767-5874 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: GA 060030111) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: GA 060030111) |
| Enumeration Date | 2011-12-08 |
| Last Update Date | 2011-12-08 |