| NPI | 1700070398 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SANDRA LEAVELL Executive Officer 770-315-5146 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: GA 4279373712500) |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: GA 4279373712500) |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2007-08-28 |