NPI 1013102177

Mental Retardation Wavier Program

Organisation Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Columbus, GA

Practice location

Address: 2100 Comer Ave, Columbus, GA 31904-8725
Phone: (706) 596-5583
Fax: (706) 596-5589

Authorised official

Name: Perry Alexander
Title: Ceo
Phone: (706) 596-5582

Registered specialties

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320900000X

Other Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities providers in Georgia →

Registry record

NPI: 1013102177
Entity type: Organization
NPI issued: 12 Sep 2007
Record last updated: 12 Sep 2007

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.