| NPI | 1902229453 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | TAMEKA LASEAN WILLIAMS Owner 678-362-4708 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320600000X Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities |
| Additional Taxonomies | 253Z00000X In Home Supportive Care |
| 385HR2060X Respite Care Respite Care, Mental Retardation and/or Developmental Disabilities | |
| Enumeration Date | 2014-02-03 |
| Last Update Date | 2014-02-03 |