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Organization
GA DEPARTMENT OF JUVENILE JUSTICE
Active
Organization
GA DEPARTMENT OF JUVENILE JUSTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDRA DEATON (FEDERAL PROGRAMS DIRECTOR)
(404) 508-6610
Entity
Organization
Contact information
Practice address
3408 COVINGTON HWY, DECATUR, GA 30032-1513
(404) 508-6610
(404) 508-5091
Mailing address
3408 COVINGTON HWY, DECATUR, GA 30032-1513
(404) 508-6610
(404) 508-5091
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
NULL
104100000X
Social Worker
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
NULL
Other
Enumeration date
02/02/2007
Last updated
09/11/2025
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