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Organization · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Jonesboro, GA

NPI

1407159585

Type

Organization (Type 2)

Primary specialty

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities)

Specialty group

Residential Treatment Facilities

Taxonomy code

320900000X

License number

031-01-246-1 (GA)

Enumerated

2010-12-13

Last updated

2010-12-13