| NPI | 1245531615 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOSHUA AIGHOBAHI Owner 770-864-1598 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: GA 067014149) |
| Enumeration Date | 2010-11-16 |
| Last Update Date | 2010-11-16 |