| NPI | 1811448822 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHAVOITA LESANE CEO 770-826-5431 |
| Organization Subpart ? | No |
| Primary Taxonomy | 324500000X Substance Abuse Rehabilitation Facility (Licence: FL MT2766) |
| Additional Taxonomies | 174400000X Specialist (Licence: FL MT2766) |
| 343900000X Non-emergency Medical Transport (VAN) (Licence: FL MT2766) | |
| Enumeration Date | 2016-10-14 |
| Last Update Date | 2016-10-14 |