| NPI | 1306981113 |
|---|---|
| Other Name | SHALLOWFORD GROUP HOME |
| Entity Type | Organization |
| Authorized Contact | FABIO BRUNO VAN DER MERWE COO 404-294-3836 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 251S00000X Community/Behavioral Health |
| Enumeration Date | 2007-02-20 |
| Last Update Date | 2024-08-19 |