| NPI | 1760826739 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANGELA S CANTRELL RN Administrator 706-315-7245 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: GA 008149) |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2013-04-22 |