NPI 1023341062

Shirley Home Away From Home

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

Practice location

Address: 8412 Red Cedar Way, Riverdale, GA 30274-4562
Phone: (678) 557-2207

Authorised official

Name: Shirley Wilson
Title: Administor
Phone: (678) 557-2207

Registered specialties

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

Residential Treatment Facilities Taxonomy 320900000X

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Registry record

NPI: 1023341062
Entity type: Organization
NPI issued: 9 Sep 2009
Record last updated: 9 Sep 2009

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.