| NPI | 1568151348 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | VICTORIA TATE Owner 770-885-2338 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2023-05-05 |
| Last Update Date | 2023-05-05 |