| NPI | 1639619307 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LATASHA STALLWORTH Owner 404-904-4282 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility (Licence: GA RPH26521) |
| Enumeration Date | 2017-02-28 |
| Last Update Date | 2017-02-28 |