| NPI | 1851960595 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | YOSEF SHUBAEV COO 404-951-6020 |
| Organization Subpart ? | No |
| Primary Taxonomy | 323P00000X Psychiatric Residential Treatment Facility |
| Additional Taxonomies | 261QM0801X Clinic/Center, Mental Health (Including Community Mental Health Center) |
| 261QR0405X Clinic/Center, Rehabilitation, Substance Use Disorder | |
| 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities | |
| Enumeration Date | 2021-06-17 |
| Last Update Date | 2021-08-12 |