Organization
SOUTHERN GROUP HOMES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JEFFREY CHARLES CHASTAIN (OWNER)
(864) 979-5397
Entity
Organization
Contact information
Practice address
5450 PLATTE DR, ELLENWOOD, GA 30294-6667
(770) 472-9113
Mailing address
PO BOX 228, EASLEY, SC 29641-0228
(770) 472-9113
(770) 216-1658
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/13/2010
Last updated
08/13/2010
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