| NPI | 1285439125 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ZECHARIAH EZEKIEL THOMAS Owner 706-412-1410 |
| Organization Subpart ? | No |
| Primary Taxonomy | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| Additional Taxonomies | 251E00000X Home Health |
| 261QM0855X Clinic/Center Adolescent and Children Mental Health | |
| 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities | |
| 323P00000X Psychiatric Residential Treatment Facility | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2025-02-14 |
| Last Update Date | 2025-02-14 |