Organization
FOOTPRINTS BEHAVIORAL SERVICES, LLC.
Active
Organization
FOOTPRINTS BEHAVIORAL SERVICES, LLC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ERICKA BLOUNT (CEO/OWNER)
(678) 490-1290
Entity
Organization
Contact information
Practice address
111 W PINE ST, VIDALIA, GA 30474-3114
(912) 537-0140
Mailing address
5205 MERRICK DR, PEACHTREE CITY, GA 30269-6701
Taxonomy
Speciality
Code
Description
License number
State
251B00000X
Case Management Agency
—
—
251S00000X
Community/Behavioral Health Agency
Primary
—
GA
251V00000X
Voluntary or Charitable Agency
—
—
Other
Enumeration date
02/23/2011
Last updated
02/23/2011
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