| NPI | 1578756532 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA DENISE COSBY CEO/Owner 770-994-2223 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251S00000X |
| Additional Taxonomies | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2007-08-23 |
| Last Update Date | 2007-08-23 |