# GEORGIA DEPT OF HUMAN RESOURCES

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Allen Hall
- **Organization subpart:** No

## Provider details

- **NPI number:** 1346353075
- **Authorized official:** MR. MARVIN BAILEY (REGIONAL HOSPITAL ADMINISTRATOR)
- **Authorized official phone:** (478) 445-4128

## Contact information

- **Practice address:** 171 ALLEN RD, MILLEDGEVILLE, GA 31062-7525
- **Practice address phone:** (478) 445-4128
- **Mailing address:** 171 ALLEN RD, MILLEDGEVILLE, GA 31062-7525

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 315P00000X | Intellectual Disabilities Intermediate Care Facility | — | NULL | Yes |

## Other

- **Enumeration date:** 08/16/2006
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 00142414A | — | GA |