| NPI | 1174710727 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KEYOKA ADWOA SHIPPMAN Office Manager 706-322-2121 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA 106-R-0024) |
| Additional Taxonomies | 251J00000X Nursing Care (Licence: GA 106-R-0024) |
| Enumeration Date | 2007-09-27 |
| Last Update Date | 2007-09-27 |