Organization
CAMP WANNA BE
Active
Parent organization
ALICE BLOUNT ACADEMY OF SCIENCE AND AGRICULTURE
Organization subpart
Yes
Provider details
NPI number
Legal business name
ALICE BLOUNT ACADEMY OF SCIENCE AND AGRICULTURE
Authorized official
MR. CLINTON BLOUNT (DIRECTOR)
(912) 537-7787
Entity
Organization
Contact information
Practice address
582 MEL BLOUNT RD, VIDALIA, GA 30474-9714
(912) 537-7787
Mailing address
582 MEL BLOUNT RD, VIDALIA, GA 30474-9714
(912) 537-7787
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YP2500X
Professional Counselor
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
3245S0500X
Children's Substance Abuse Rehabilitation Facility
—
—
385H00000X
Respite Care
—
—
Other
Enumeration date
08/03/2012
Last updated
08/03/2012
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