| NPI | 1558990341 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DELLANEY LASHAY JOHNSON DIDDELL Owner 912-322-2473 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center, Adult Day Care |
| Additional Taxonomies | 174200000X |
| Enumeration Date | 2020-04-03 |
| Last Update Date | 2020-04-03 |