| NPI | 1710472857 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHANITA POND Owner 912-257-9346 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: GA PCH009279) |
| Enumeration Date | 2018-06-29 |
| Last Update Date | 2018-06-29 |