| NPI | 1154515906 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ROSETTA JOHNSON Owner 770-484-3034 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: GA 044016619) |
| Enumeration Date | 2007-09-04 |
| Last Update Date | 2007-09-04 |