| NPI | 1144620170 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TYEAST REYNOLDS Director Of Rcm 678-813-0428 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Enumeration Date | 2014-08-27 |
| Last Update Date | 2019-04-11 |