| NPI | 1639489404 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EDGAR CARNELL BONES Adminstrator 478-285-4732 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: GA 200217071386) |
| Enumeration Date | 2010-10-14 |
| Last Update Date | 2010-10-14 |