| NPI | 1144521428 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TERESSA DOUGLAS Owner 404-228-7985 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: GA 031012958) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: GA 031012958) |
| Enumeration Date | 2010-11-03 |
| Last Update Date | 2010-11-03 |