| NPI | 1275678526 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAMES JACKSON Interm Regional Hospital Administra 706-790-2030 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2020-08-22 |