| NPI | 1255605408 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WANDA CATHERINE HAWKINS Administrator 678-851-7278 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251J00000X Nursing Care |
| Additional Taxonomies | 251B00000X Case Management |
| 251F00000X Home Infusion | |
| 251X00000X Supports Brokerage | |
| 311ZA0620X Custodial Care Facility, Adult Care Home | |
| Enumeration Date | 2012-03-06 |
| Last Update Date | 2012-03-06 |