| NPI | 1396047452 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY B JACKSON Owner/Administrator 229-317-2040 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: GA 047-R-0510) |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| Enumeration Date | 2010-11-23 |
| Last Update Date | 2023-07-03 |