| NPI | 1861937443 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | EULANDA LARA WALLER Administrator 478-318-2313 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QA0600X Clinic/Center Adult Day Care (Licence: GA ADC000150) |
| Additional Taxonomies | 311Z00000X Custodial Care Facility (Licence: GA ADC000150) |
| Enumeration Date | 2017-01-05 |
| Last Update Date | 2017-08-21 |