| NPI | 1154486496 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TASHUA GRIZZLE Administrator 404-212-4676 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: GA 044232) |
| Enumeration Date | 2006-12-27 |
| Last Update Date | 2009-08-18 |