NPI 1043541915

Clover House, LLC

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

Practice location

Address: 496 N Avery Rd NW, Rome, GA 30165-7970
Phone: (706) 295-2388
Fax: (706) 413-1719

Authorised official

Name: Darrell a Creel
Title: Clover House Home Manager
Phone: (706) 295-2388

Registered specialties

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

Residential Treatment Facilities Taxonomy 320900000X Licence 057-01-039-1 (GA)

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

Registry record

NPI: 1043541915
Entity type: Organization
NPI issued: 16 Jan 2010
Record last updated: 16 Jan 2010

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.