NPI 1043580384
K Gibss Host Home
Practice location
- Address
- 1435 Jody Hall Dr, Elberton, GA 30635-4510
- Phone
- (706) 621-2079
- Mailing address
- 250 North Ave, Athens, GA 30601-2244
Authorised official
- Name
- Glenn Butler
- Title
- Billing Mgr
- Phone
- (706) 389-6789
Registered specialties
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
Registry record
- NPI
- 1043580384
- Entity type
- Organization
- NPI issued
- 4 Jan 2012
- Record last updated
- 4 Jan 2012
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.