NPI | 1225319304 |
---|---|
Other Name | FOX AVENUE |
Entity Type | Organization |
Authorized Contact | JENNIFER D LOZANO Director Of Revenue Cycle 404-364-2900 |
Organization Subpart ? | No |
Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
Enumeration Date | 2011-09-02 |
Last Update Date | 2015-09-16 |