Organization
MOUNT EAGLES WINGS INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. VENNA SHARELL REESE HEATHCARE PROVIDER (CEO/ADMINISTRATOR)
(706) 284-9959
Entity
Organization
Contact information
Practice address
4027 PRESCOTT DR, MARTINEZ, GA 30907-4308
(706) 284-9959
Mailing address
4027 PRESCOTT DR, MARTINEZ, GA 30907-4308
(706) 284-9959
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
—
—
Other
Enumeration date
04/07/2012
Last updated
04/07/2012
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