| NPI | 1235431651 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PATRICIA ANTHONY Owner 770-996-0508 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: GA 060012271) |
| Enumeration Date | 2010-11-18 |
| Last Update Date | 2010-11-18 |