NPI 1265509806

Georgia Department of Human Resources

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

Practice location

Address: 4114 Pinnacle Pines CT, Hephzibah, GA 30815-6137
Phone: (706) 790-2034
Mailing address: 100 Myrtle Blvd, Gracewood, GA 30812-1500

Authorised official

Name: Gail C Jackson
Title: Regional Hospital Administrator
Phone: (706) 790-2030

Registered specialties

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

Residential Treatment Facilities Taxonomy 320900000X

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

Registry record

NPI: 1265509806
Entity type: Organization
NPI issued: 29 Nov 2006
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.