| NPI | 1467672337 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | STACEY CATRICE WATSON-GAITHER Executive Director 678-851-8822 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X (Licence: GA 044-607-D) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: GA 044-607-D) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2020-08-22 |