| NPI | 1760831507 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | KADJI TANYI Program Administrator 404-637-6147 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310500000X Intermediate Care Facility, Mental Illness |
| Enumeration Date | 2016-06-11 |
| Last Update Date | 2016-06-11 |