| NPI | 1295984425 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE ENNIS MCGEE Manager 678-445-4833 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: IL C/A-0538-0028-A) |
| Enumeration Date | 2008-09-11 |
| Last Update Date | 2021-12-16 |