| NPI | 1669189783 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREA SMITH Director 770-369-6751 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Additional Taxonomies | 261QM0850X Clinic/Center, Adult Mental Health |
| 261QM0855X Clinic/Center, Adolescent and Children Mental Health | |
| Enumeration Date | 2022-10-28 |
| Last Update Date | 2022-10-31 |