| NPI | 1942588587 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ELMIRA ELAINE ROULHAC Administrator 706-306-1157 |
| Organization Subpart ? | No |
| Primary Taxonomy | 171M00000X Case Manager/Care Coordinator (Licence: GA 359961093A) |
| Enumeration Date | 2011-08-01 |
| Last Update Date | 2011-08-01 |