Organization
THE REGENERATION PROJECT
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. BRENDA WILLIAMS (PROGRAM DIRECTOR)
(478) 971-4684
Entity
Organization
Contact information
Practice address
378 TABOR RD, FORT VALLEY, GA 31030-6024
(478) 971-4684
Mailing address
378 TABOR RD, FORT VALLEY, GA 31030-6024
(478) 971-4684
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
424986876A
—
GA
Enumeration date
10/22/2009
Last updated
10/22/2009
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