| NPI | 1376603001 |
|---|---|
| Other Name | MONROE |
| Entity Type | Organization |
| Authorized Contact | JENNIFER D LOZANO Director Of Revenue Cycle 404-968-2663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 315P00000X Intermediate Care Facility, Intellectual Disabilities (Licence: NC MHL-060-222) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-060-222) |
| Enumeration Date | 2006-12-11 |
| Last Update Date | 2015-09-19 |