| NPI | 1255856985 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANOUCHEKA NELSON Credentialing Specialist 470-435-1329 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL 00000) |
| Enumeration Date | 2017-08-03 |
| Last Update Date | 2022-07-21 |