| NPI | 1457623308 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RONDINE GORDON Owner/Administrator 770-573-1076 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: GA PCH006520) |
| Additional Taxonomies | 311Z00000X Custodial Care Facility (Licence: GA PCH006520) |
| 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: GA PCH006520) | |
| Enumeration Date | 2012-02-07 |
| Last Update Date | 2012-02-07 |