| NPI | 1124085451 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MATT HATCHER COO 229-439-7061 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: GA 047-R-0011) |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services (Licence: GA 047-R-0011) |
| 332B00000X Durable Medical Equipment & Medical Supplies (Licence: GA 047-R-0011) | |
| 385HR2060X Respite Care, Respite Care, Intellectual and/or Developmental Disabilities, Child (Licence: GA 047-r-011) | |
| Enumeration Date | 2006-04-28 |
| Last Update Date | 2021-01-24 |