# PREDESTINED FOR GREATNESS

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

## Provider details

- **NPI number:** 1154537181
- **Authorized official:** MR. DION THOMAS (CEO)
- **Authorized official phone:** (770) 320-9278

## Contact information

- **Practice address:** 4865 BROOKSTONE PKWY, ELLENWOOD, GA 30294-2126
- **Practice address phone:** (770) 320-9278
- **Mailing address:** 4865 BROOKSTONE PKWY, ELLENWOOD, GA 30294-2126
- **Mailing address phone:** (770) 320-9278

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 322D00000X | Emotionally Disturbed Childrens' Residential Treatment Facility | CCI001578 | GA | Yes |

## Other

- **Enumeration date:** 05/15/2007
- **Last updated:** 08/22/2020