| NPI | 1134402233 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHERLEY JUSSOME Owner 678-914-1300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: GA 2011017922) |
| Enumeration Date | 2011-09-25 |
| Last Update Date | 2011-09-25 |