| NPI | 1851626733 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | GERALD DAVID TILLMAN Director 404-401-1094 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: GA 044017288) |
| Enumeration Date | 2009-10-09 |
| Last Update Date | 2009-10-09 |