| NPI | 1821392572 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ISAAC T MILLER CEO 706-869-0775 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: GA 121014201) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: GA 121014201) |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2011-01-10 |