NPI 1154537181

Predestined for Greatness

Organisation Emotionally Disturbed Childrens' Residential Treatment Facility Ellenwood, GA

Practice location

Address: 4865 Brookstone Pkwy, Ellenwood, GA 30294-2126
Phone: (770) 320-9278

Authorised official

Name: Dion Thomas
Title: Ceo
Phone: (770) 320-9278

Registered specialties

Emotionally Disturbed Childrens' Residential Treatment Facility Primary

Residential Treatment Facilities Taxonomy 322D00000X Licence CCI001578 (GA)

Other Residential Treatment Facility, Emotionally Disturbed Children providers in Georgia →

Registry record

NPI: 1154537181
Entity type: Organization
NPI issued: 15 May 2007
Record last updated: 22 Aug 2020

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.