NPI 1134564131

Panola Care, Cla

Organisation Intellectual and/or Developmental Disabilities Residential Treatment Facility Lithonia, GA

Practice location

Address: 3169 Pequea Dr, Lithonia, GA 30038-1119
Phone: (770) 322-6810
Fax: (770) 322-6810

Authorised official

Name: Carol a Tavares
Title: Director
Phone: (770) 322-6810

Registered specialties (2)

Intellectual and/or Developmental Disabilities Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 320600000X

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

Physical Disabilities Residential Treatment Facility

Residential Treatment Facilities Taxonomy 320700000X

Other Residential Treatment Facility, Physical Disabilities providers in Georgia →

Registry record

NPI: 1134564131
Entity type: Organization
NPI issued: 3 May 2013
Record last updated: 3 May 2013

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.