| NPI | 1780954024 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GLENN BUTLER Billing Mgr 706-389-6789 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2012-01-04 |
| Last Update Date | 2012-09-20 |