| NPI | 1265779912 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LURLENE SMALLWOOD Owner/Provider 404-496-9970 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: GA 033013341) |
| Enumeration Date | 2013-01-14 |
| Last Update Date | 2013-01-14 |