| NPI | 1346952850 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JAIMY BROCK Director Of Compliance 678-334-6651 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2022-12-15 |
| Last Update Date | 2023-04-21 |