| NPI | 1649424789 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHONTAON MICHELLE DEAN Lpn 478-988-1222 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2008-11-14 |
| Last Update Date | 2022-07-21 |