| NPI | 1245576644 |
|---|---|
| Former Legal Business Name | GRN COMMUNITY SERVICE BOARD |
| Entity Type | Organization |
| Authorized Contact | AMANDA LEDBETTER Billing Manager 678-209-2355 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: GA PCH004140) |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2016-01-14 |