Organization
APFA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. JANET BECK (CEO)
(770) 401-8028
Entity
Organization
Contact information
Practice address
4776 BEN HILL RD, DOUGLASVILLE, GA 30134-4213
(770) 401-8028
(770) 401-8028
Mailing address
4776 BEN HILL RD, DOUGLASVILLE, GA 30134-4213
(770) 401-8028
(770) 401-8028
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
PCH0007146
GA
320700000X
Physical Disabilities Residential Treatment Facility
PCH0007146
GA
Other
Enumeration date
06/07/2012
Last updated
06/07/2012
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