| NPI | 1629724083 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TRIPHENA CHANEL SMALLS Member 404-313-5009 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Additional Taxonomies | 251J00000X Nursing Care |
| Enumeration Date | 2022-02-24 |
| Last Update Date | 2025-06-04 |