| NPI | 1912205584 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | JESSE MARTIN CEO 404-245-6292 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320800000X Community Based Residential Treatment Facility, Mental Illness |
| Additional Taxonomies | 324500000X Substance Abuse Rehabilitation Facility (Licence: GA 031-01-308-9) |
| Enumeration Date | 2011-03-07 |
| Last Update Date | 2011-03-07 |