| NPI | 1407158231 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANTERIA LASHUN MCKNIGHT Director 678-643-3600 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 323P00000X Psychiatric Residential Treatment Facility |
| Enumeration Date | 2010-11-30 |
| Last Update Date | 2010-11-30 |