| NPI | 1104687565 |
|---|---|
| Doing Business As | TERRANCE PARKS |
| Entity Type | Organization |
| Authorized Contact | TERRANCE PARKS Owner/Director 678-446-7286 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2024-01-22 |
| Last Update Date | 2024-01-30 |