| NPI | 1902296866 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICOLE BENTLEY Owner 706-306-0273 |
| Organization Subpart ? | No |
| Primary Taxonomy | 311Z00000X Custodial Care Facility (Licence: GA lcb20130000967) |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2015-01-30 |