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Organization

EXTENDING COMMUNITY SERVICES FOUNDATION

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MS. LATASHA D GUY (OWNER/OPERATOR)
(404) 520-7308
Entity
Organization

Contact information

Practice address
3630 EMERALD PT, DECATUR, GA 30034-5739
(678) 750-3273
Mailing address
3630 EMERALD PT, DECATUR, GA 30034-5739
(678) 750-3273

Taxonomy

Speciality
Code
Description
License number
State
315P00000X
Intellectual Disabilities Intermediate Care Facility
Primary

Other

Enumeration date
10/29/2012
Last updated
10/29/2012
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