| NPI | 1861778748 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | FELICIA J BURNS Owner 706-306-0074 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311ZA0620X Custodial Care Facility, Adult Care Home (Licence: GA LCB2011001155) |
| Additional Taxonomies | 310400000X Assisted Living Facility (Licence: GA PCH007134) |
| Enumeration Date | 2011-10-24 |
| Last Update Date | 2011-10-24 |