| NPI | 1851078067 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | RENITA C MOORE GRAVES Director 404-437-5039 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home |
| Enumeration Date | 2023-06-29 |
| Last Update Date | 2023-06-29 |