| NPI | 1699138669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BARBARA RANDALL Ex. Directory 770-912-5664 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: GA 00139008) |
| Enumeration Date | 2016-03-29 |
| Last Update Date | 2016-03-29 |