| NPI | 1225158371 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GRETCHEN V JACCINO President 770-879-0817 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QD1600X Clinic/Center, Developmental Disabilities (Licence: GA 00016) |
| Enumeration Date | 2007-03-30 |
| Last Update Date | 2020-08-22 |