Organization
RESIDENTIAL LIVING, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. VALERIA BRODERICK (EXECUTIVE DIRECTOR)
(770) 885-3966
Entity
Organization
Contact information
Practice address
7861 COLLINSWOOD CT, JONESBORO, GA 30236-3399
(678) 489-5700
(678) 489-3009
Mailing address
7861 COLLINSWOOD CT, JONESBORO, GA 30236-3399
(678) 489-5700
(678) 489-3009
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
10/27/2010
Last updated
10/27/2010
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