| NPI | 1659099414 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BRANDON L OWENS Owner 678-856-7172 |
| Organization Subpart ? | No |
| Primary Taxonomy | 251C00000X Day Training, Developmentally Disabled Services |
| Additional Taxonomies | 101YM0800X Counselor, Mental Health |
| 251S00000X | |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 343900000X Non-emergency Medical Transport (VAN) | |
| Enumeration Date | 2022-08-18 |
| Last Update Date | 2022-08-18 |