| NPI | 1770066029 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOHNNY SUMMERS Owner 678-490-1723 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Enumeration Date | 2018-09-12 |
| Last Update Date | 2018-10-04 |