Organization
STELLAVILLA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CAROL DELORES SHAW (DIRECTOR)
(770) 593-2539
Entity
Organization
Contact information
Practice address
3848 CAIN MILL DR, LITHONIA, GA 30038-3868
(770) 593-2539
(770) 593-0691
Mailing address
3848 CAIN MILL DR, LITHONIA, GA 30038-3868
(770) 593-2539
(770) 593-0691
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
Other
Enumeration date
03/05/2007
Last updated
08/22/2020
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