| NPI | 1902080831 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TABITHA ANTIONETTE JOHNSON-GREEN Owner/Administrator 478-552-3560 |
| Organization Subpart ? | No |
| Primary Taxonomy | 310400000X Assisted Living Facility (Licence: GA 150010039) |
| Enumeration Date | 2007-12-27 |
| Last Update Date | 2007-12-27 |