| NPI | 1841624095 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JOCELYN LYN HAMMPMD Home Health Aide 770-374-0862 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: GA CN0019212211) |
| Enumeration Date | 2013-08-23 |
| Last Update Date | 2013-08-23 |