| NPI | 1205988631 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAISY LOUISE FERGUSON Lpn 706-667-4282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251K00000X Public Health or Welfare (Licence: GA LPN039414) |
| Enumeration Date | 2007-01-17 |
| Last Update Date | 2020-08-22 |