| NPI | 1538282744 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOLANDA D JACKSON Owner 229-889-8287 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: GA 047020601) |
| Enumeration Date | 2007-04-10 |
| Last Update Date | 2008-06-26 |