| NPI | 1316221815 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONDINE D GORDON CEO 770-573-1076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: GA PCH008079) |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: GA PCH008079) |
| Enumeration Date | 2011-10-03 |
| Last Update Date | 2011-10-03 |