| NPI | 1114858867 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JENNIFER D LOZANO SVP Financial Services 770-630-7290 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2026-05-28 |
| Last Update Date | 2026-05-28 |