NPI 1316279557

Allegiant Service LLC

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

Practice location

Address: 4323 Juneberry CT, Decatur, GA 30034-6425
Phone: (678) 491-6215
Fax: (770) 558-1580

Authorised official

Name: Mary Ann Ferguson
Title: Administrator
Phone: (678) 491-6215

Registered specialties

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

Residential Treatment Facilities Taxonomy 320900000X Licence 126168557A (GA)

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Registry record

NPI: 1316279557
Entity type: Organization
NPI issued: 12 Feb 2010
Record last updated: 12 Feb 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.