| NPI | 1770996001 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | HENRY S REAVES Cna 267-303-3999 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: GA CN0014197375) |
| Enumeration Date | 2014-06-04 |
| Last Update Date | 2014-06-04 |