| NPI | 1699191700 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENEE ENNIS MCGEE Manager 678-445-4833 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: IL C/A-0538-0050-A) |
| Enumeration Date | 2014-03-13 |
| Last Update Date | 2018-09-24 |