| NPI | 1841596905 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FRANK LAMONTE LEATH CEO 678-522-6413 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: NC FCL-001-138) |
| Enumeration Date | 2011-02-07 |
| Last Update Date | 2011-03-10 |