Organization
TWIN OAKS
Active
Parent organization
CAMP WANNA BE, INC
Other names
Camp Wanna Be, In
Organization subpart
Yes
Provider details
NPI number
Legal business name
CAMP WANNA BE, INC
Authorized official
MR. CLINTON BLOUNT CEO (PRESIDENT)
(912) 537-7758
Entity
Organization
Contact information
Practice address
582 MEL BLOUNT RD, VIDALIA, GA 30474-9714
(912) 537-7758
(912) 537-0825
Mailing address
218 BUCKHORN CREEK RD, VIDALIA, GA 30474-9759
(912) 537-7787
(912) 537-0825
Taxonomy
Speciality
Code
Description
License number
State
302F00000X
Exclusive Provider Organization
138-01-010-9
GA
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
138-01-010-9
GA
Other
Enumeration date
01/07/2009
Last updated
01/07/2009
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