| NPI | 1093114423 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTA SMITH Owner/Adminstrator 678-702-4639 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: GA PCH008442) |
| Enumeration Date | 2014-08-21 |
| Last Update Date | 2014-08-21 |