Organization
THE WINGS OF HOLLY BLUE LLC
Active
Other names
TWOHB
Organization subpart
No
Provider details
NPI number
Authorized official
DEBRA HOWARD (CEO)
(760) 585-5522
Entity
Organization
Contact information
Practice address
815 S MAIN ST, MOULTRIE, GA 31768-5434
(760) 585-5522
(760) 433-5414
Mailing address
815 S MAIN ST, MOULTRIE, GA 31768-5434
(760) 585-5522
(760) 433-5414
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
02/27/2024
Last updated
04/11/2024
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