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Organization
CHESTNUT MANOR, INC.
Active
Organization
CHESTNUT MANOR, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SHIRLEY NAPIER-BRADY (EXECUTIVE DIRECTOR)
(770) 920-9369
Entity
Organization
Contact information
Practice address
8673 CHESTNUT LN, LITHIA SPRINGS, GA 30122-3410
(770) 920-9369
Mailing address
8673 CHESTNUT LN, LITHIA SPRINGS, GA 30122-3410
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
12040
GA
343900000X
Non-emergency Medical Transport (VAN)
12040
GA
385HR2060X
Child Intellectual and/or Developmental Disabilities Respite Care
12040
GA
Other
Enumeration date
11/04/2011
Last updated
11/04/2011
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