NPI 1861861361

Child, Youth, Adolescents, and Families

Organisation Mental Illness Intermediate Care Facility Morrow, GA

Practice location

Address: 1396 Southlake Plaza Dr, Morrow, GA 30260-1756
Phone: (770) 473-2640
Fax: (770) 473-2601

Authorised official

Name: Elanta Thomas
Title: Registered Nurse
Phone: (770) 478-2640

Registered specialties

Mental Illness Intermediate Care Facility Primary

Nursing & Custodial Care Facilities Taxonomy 310500000X Licence RN228517 (GA)

Other Intermediate Care Facility, Mental Illness providers in Georgia →

Registry record

NPI: 1861861361
Entity type: Organization
NPI issued: 15 Sep 2015
Record last updated: 15 Sep 2015

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.