| NPI | 1598037426 |
|---|---|
| Doing Business As | N/A |
| Entity Type | Organization |
| Authorized Contact | REBECCA M AIDOO Administrator 678-319-0307 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: GA 060-R-0501) |
| Enumeration Date | 2012-02-08 |
| Last Update Date | 2012-02-08 |