Organization
RESPITE RETREAT, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTINE OWEN MA (OFFICER)
(706) 781-3155
Entity
Organization
Contact information
Practice address
1256 OLD GUM LOG RD, BLAIRSVILLE, GA 30512-2065
(706) 781-3155
Mailing address
PO BOX 2703, BLAIRSVILLE, GA 30514-2703
(706) 897-4237
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
385HR2055X
Child Mental Illness Respite Care
—
—
Other
Enumeration date
08/10/2017
Last updated
08/10/2017
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