| NPI | 1972872695 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | QUINIA FAULKNER Owner 770-855-3698 |
| Organization Subpart ? | No |
| Primary Taxonomy | 320900000X Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities |
| Enumeration Date | 2011-12-27 |
| Last Update Date | 2011-12-27 |