Organization
DEVELOPMENTAL ENRICHMENT SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. GRETCHEN V JACCINO OTR (PRESIDENT)
(770) 879-0817
Entity
Organization
Contact information
Practice address
3615 S ROCKBRIDGE RD, STONE MOUNTAIN, GA 30087-4408
(770) 879-0817
Mailing address
3615 S ROCKBRIDGE RD, STONE MOUNTAIN, GA 30087-4408
(770) 879-0817
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
00016
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00599035
—
GA
Enumeration date
03/30/2007
Last updated
08/22/2020
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