# BIG BEN'SGROUP HOME

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

## Provider details

- **NPI number:** 1407869951
- **Authorized official:** MR. BENNIE EARL GRIFFIN (ADMINISTER)
- **Authorized official phone:** (334) 655-5406

## Contact information

- **Practice address:** 112 N BELL ST, DOTHAN, AL 36303-4308
- **Practice address phone:** (334) 793-5406
- **Practice address fax:** (334) 793-5406
- **Mailing address:** 112 N BELL ST, DOTHAN, AL 36303-4308
- **Mailing address phone:** (334) 793-5406
- **Mailing address fax:** (334) 793-5406

## Taxonomy

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

## Other

- **Enumeration date:** 08/15/2006
- **Last updated:** 08/22/2020