Organization
GOLDEN GENERATION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA MOYD B.A. BUSINESS (ADMINISTRATOR)
(706) 339-6749
Entity
Organization
Contact information
Practice address
351 KINGS BRIDGE RD, MARTINEZ, GA 30907-9616
(706) 339-6749
Mailing address
351 KINGS BRIDGE RD, MARTINEZ, GA 30907-9616
(706) 339-6749
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
146305913A
GA
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
146305913B
GA
Other
Enumeration date
10/10/2013
Last updated
10/10/2013
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