# RESPITE RETREAT, INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073038063
- **Authorized official:** CHRISTINE OWEN MA (OFFICER)
- **Authorized official phone:** (706) 781-3155

## Contact information

- **Practice address:** 1256 OLD GUM LOG RD, BLAIRSVILLE, GA 30512-2065
- **Practice address phone:** (706) 781-3155
- **Mailing address:** PO BOX 2703, BLAIRSVILLE, GA 30514-2703
- **Mailing address phone:** (706) 897-4237

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QM0801X | Mental Health Clinic/Center (Including Community Mental Health Center) | — | NULL | — |
| 261QM0855X | Adolescent and Children Mental Health Clinic/Center | — | NULL | Yes |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | — | NULL | — |
| 385HR2055X | Child Mental Illness Respite Care | — | NULL | — |

## Other

- **Enumeration date:** 08/10/2017
- **Last updated:** 08/10/2017