| NPI | 1477612562 |
|---|---|
| Other Name | NEVINS 1 |
| Entity Type | Organization |
| Authorized Contact | JENNIFER D LOZANO Director Of Revenue Cycle 404-968-2663 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC MHL-060-198) |
| Additional Taxonomies | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: NC MHL-060-198) |
| Enumeration Date | 2006-12-06 |
| Last Update Date | 2015-09-19 |