| NPI | 1346654605 |
|---|---|
| Former Legal Business Name | NA |
| Entity Type | Organization |
| Authorized Contact | RONNIE E BASS Executive Director 678-234-2445 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X Community/Behavioral Health (Licence: GA GA0117) |
| Additional Taxonomies | 282NC0060X General Acute Care Hospital Critical Access (Licence: GA GA0117) |
| Enumeration Date | 2014-06-16 |
| Last Update Date | 2014-06-16 |