| NPI | 1417232638 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRADFORD GILES Owner 404-771-9133 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: GA 444746012A) |
| Enumeration Date | 2011-10-19 |
| Last Update Date | 2011-10-19 |