| NPI | 1417198458 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARY ANN SLADE President 678-847-1353 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility |
| Additional Taxonomies | 322D00000X Residential Treatment Facility, Emotionally Disturbed Children |
| 3245S0500X Substance Abuse Rehabilitation Facility, Substance Abuse Treatment, Children | |
| Enumeration Date | 2009-03-22 |
| Last Update Date | 2009-03-22 |