| NPI | 1861789380 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CASSANDRA SIMONE HICKS Health Systems Manager 770-666-4401 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2011-07-05 |
| Last Update Date | 2011-07-05 |