| NPI | 1578259289 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MADELINE FORD Owner 770-733-5833 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QR0800X Clinic/Center, Recovery Care | |
| Enumeration Date | 2023-04-14 |
| Last Update Date | 2023-07-17 |