| NPI | 1649342502 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MANAGED CARE Manager, Provider Enrollment 404-785-7876 |
| Organization Subpart ? | No |
| Primary Taxonomy | 273Y00000X Rehabilitation Unit (Licence: GA 044-079) |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2024-09-27 |