| NPI | 1376792127 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CAROLYN DARLENE MATTIS CEO 404-243-5484 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251C00000X Day Training, Developmentally Disabled Services |
| 251S00000X | |
| Enumeration Date | 2008-09-17 |
| Last Update Date | 2008-09-17 |