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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