Organization
KELLY TOWN FAMILY GROUP
Active
Other names
Health Care connect group
Organization subpart
No
Provider details
NPI number
Authorized official
MS. TERRIE PETERS (OWNER)
(678) 353-4677
Entity
Organization
Contact information
Practice address
618 MEDWAY DRIVE, MCDONOUGH, GA 30253
(678) 353-4677
Mailing address
618 MEDWAY DR, MCDONOUGH, GA 30252-4155
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
20100006464
AL
Other
Enumeration date
10/19/2010
Last updated
10/19/2010
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