| NPI | 1407094212 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JUAN CARLOS MALPARTIDA Owner 706-259-5579 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care (Licence: GA 50406) |
| Additional Taxonomies | 261QA0600X Clinic/Center, Adult Day Care (Licence: GA 53528) |
| Enumeration Date | 2009-02-02 |
| Last Update Date | 2009-02-02 |