Organization
PEACEFUL RIVER RESIDENTIAL SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA S WILLIAMS (OWNER)
(706) 681-4211
Entity
Organization
Contact information
Practice address
746 RUDGATE RD, COLUMBUS, GA 31904-2929
(706) 571-8859
(706) 243-6357
Mailing address
746 RUDGATE RD, COLUMBUS, GA 31904-2929
(706) 571-8859
(706) 243-6357
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
CLA001207
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003136088A
—
GA
Enumeration date
03/01/2016
Last updated
03/01/2016
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