| NPI | 1912200841 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | PHILOMENA WRIGHT Administrator 678-612-2395 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2010-12-15 |
| Last Update Date | 2010-12-15 |