NPI 1619424231
Devereux Goergia Treatment Network
Practice location
- Address
- 1291 Stanley Rd, Kennesaw, GA 30152
- Phone
- (770) 427-0147
- Mailing address
- 1291 Stanley Rd NW, Kennesaw, GA 30152-4359
Authorised official
- Name
- Yolanda Patrice Graham
- Title
- Medical Director
- Phone
- (770) 427-0147
Registered specialties
Psychiatric Residential Treatment Facility
Primary
Registry record
- NPI
- 1619424231
- Entity type
- Organization
- NPI issued
- 1 Sep 2016
- Record last updated
- 1 Sep 2016
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.