| NPI | 1942619010 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NATASHA SUZANNE VITART Speech Language Pathologist 770-432-4444 |
| Organization Subpart ? | No |
| Primary Taxonomy | 314000000X Skilled Nursing Facility |
| Enumeration Date | 2014-08-04 |
| Last Update Date | 2015-01-26 |