| NPI | 1396413027 |
|---|---|
| Other Name | AUTUMN TERRACE #3 |
| Entity Type | Organization |
| Authorized Contact | MICHAEL SHANE SHRIVER President 404-273-2361 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2021-08-30 |
| Last Update Date | 2021-08-30 |