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Organization
RIDGE CREEK, INC.
Active
Organization
RIDGE CREEK, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. LEN BUCCELLATO PH.D. (PRESIDENT)
(706) 864-4730
Entity
Organization
Contact information
Practice address
830 HIDDEN LAKE RD, DAHLONEGA, GA 30533-1875
(706) 864-4730
Mailing address
830 HIDDEN LAKE RD, DAHLONEGA, GA 30533-1875
(706) 864-4730
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
CCI001713
GA
Other
Enumeration date
04/30/2008
Last updated
04/30/2008
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