| NPI | 1891788097 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | BEVERLY B. BAJERSKI Regional Hospital Administrator 229-227-3021 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Enumeration Date | 2005-08-24 |
| Last Update Date | 2020-08-22 |