| NPI | 1124628144 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANNON TANESHIA PERKINS Director 229-415-9148 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 385H00000X Respite Care |
| Enumeration Date | 2020-10-28 |
| Last Update Date | 2020-10-28 |