| NPI | 1326713256 |
|---|---|
| Other Name | AUTUMN TERRACE #2 |
| Entity Type | Organization |
| Authorized Contact | MICHAEL SHANE SHRIVER President 404-273-2361 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2021-08-12 |
| Last Update Date | 2021-08-12 |