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Organization
MY FATHERS ESTATE, LLC
Active
Organization
MY FATHERS ESTATE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHIRLEY BROWN (CEO)
(770) 356-2479
Entity
Organization
Contact information
Practice address
1928 FLAT ROCK RD, STOCKBRIDGE, GA 30281-2039
(770) 356-2479
(770) 474-3904
Mailing address
1928 FLAT ROCK RD, STOCKBRIDGE, GA 30281-2039
(770) 356-2479
(770) 474-3904
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
075010578
GA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
075010578
GA
Other
Enumeration date
11/08/2010
Last updated
11/08/2010
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