| NPI | 1437481116 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | WILLIE MAE SMITH Director/Manager 770-482-8215 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: GA 00157470) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: GA 00157470) |
| Enumeration Date | 2010-02-05 |
| Last Update Date | 2012-10-25 |