Organization
RITCHGLOW COMPANY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DAWN FREDERICKS (MANAGER)
(404) 597-5767
Entity
Organization
Contact information
Practice address
2717 RAINBOW FOREST DR, DECATUR, GA 30034-1925
(404) 288-2451
(404) 284-0748
Mailing address
3821 BUTTERNUT DR, DECATUR, GA 30034-4543
(404) 597-5767
(404) 284-0748
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
08/30/2010
Last updated
08/30/2010
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