| NPI | 1881354132 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JERRAD ANDERSON Owner 706-267-4433 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility |
| Additional Taxonomies | 363LG0600X Nurse Practitioner Gerontology |
| Enumeration Date | 2021-12-28 |
| Last Update Date | 2021-12-30 |