NPI | 1619204906 |
---|---|
Entity Type | Organization |
Authorized Contact | VENNA REESE Owner/Administratot 706-284-9959 |
Organization Subpart ? | No |
Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
Additional Taxonomies | 311Z00000X Custodial Care Facility |
Enumeration Date | 2009-11-08 |
Last Update Date | 2009-11-08 |