| NPI | 1487858528 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ANGELO CROMWELL Manager 404-207-6387 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2020-08-22 |