| NPI | 1861679367 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CATHI AUCOIN Gl Manager 470-235-4700 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 320700000X Residential Treatment Facility, Physical Disabilities (Licence: UT 13347) |
| Additional Taxonomies | 320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: UT 13347) |
| 261QA0600X Clinic/Center, Adult Day Care | |
| 320700000X Residential Treatment Facility, Physical Disabilities | |
| 320800000X Community Based Residential Treatment Facility, Mental Illness (Licence: UT 13347) | |
| 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities (Licence: UT 13347) | |
| Enumeration Date | 2008-01-28 |
| Last Update Date | 2019-01-23 |