| NPI | 1205158813 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KAREN TUCKER Billing Manager 678-513-5700 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: GA MSW004930) |
| Enumeration Date | 2010-02-23 |
| Last Update Date | 2010-02-23 |