| NPI | 1528236320 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MARGARET JORDAN Utilization Manager 229-815-5286 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251S00000X |
| Enumeration Date | 2008-02-14 |
| Last Update Date | 2021-12-29 |