Organization
THE OLIVIA CENTER FOR DEVELOPMENTAL DISABILITIES, LLC
Active
Organization
THE OLIVIA CENTER FOR DEVELOPMENTAL DISABILITIES, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. TARA KELLY WILLIAMS (OWNER)
(770) 899-5311
Entity
Organization
Contact information
Practice address
11050 CRABAPPLE RD, SUITE C-109, ROSWELL, GA 30075-2489
(770) 899-5311
Mailing address
11050 CRABAPPLE RD, SUITE C-109, ROSWELL, GA 30075-2489
(770) 899-5311
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
GA
251S00000X
Community/Behavioral Health Agency
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
662980423A
—
GA
05
—
662980423B
—
GA
Enumeration date
06/13/2011
Last updated
06/13/2011
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