NPI 1114237567

Kelly Town Family Group

Organisation Mental Illness Community Based Residential Treatment Facility McDonough, GA

Practice location

Address: 618 Medway Drive, McDonough, GA 30253
Phone: (678) 353-4677
Mailing address: 618 Medway Dr, McDonough, GA 30252-4155

Authorised official

Name: Terrie Peters
Title: Owner
Phone: (678) 353-4677

Registered specialties

Mental Illness Community Based Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320800000X Licence 20100006464 (AL)

Other Community Based Residential Treatment Facility, Mental Illness providers in Georgia →

Registry record

NPI: 1114237567
Entity type: Organization
NPI issued: 19 Oct 2010
Record last updated: 19 Oct 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.