| NPI | 1174823595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZANNIE DARRELL BLACK Owner 678-557-8969 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: GA 031012928) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: GA 031012928) |
| Enumeration Date | 2010-11-01 |
| Last Update Date | 2010-11-01 |