| NPI | 1215153770 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLORIA A RODGERS Coordinator 706-320-9012 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2008-07-21 |