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Organization
REACH FOR THE MOON INC
Active
Organization
REACH FOR THE MOON INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MELVIN MOON SR. (CEO)
(678) 425-3231
Entity
Organization
Contact information
Practice address
714 BASKINS CIR, WINDER, GA 30680-3584
(678) 425-9602
Mailing address
714 BASKINS CIR, WINDER, GA 30680-3584
(678) 425-9602
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
129815246A
GA
Other
Enumeration date
09/07/2010
Last updated
09/07/2010
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