Organization
KENNETH B WALKER RESIDENTIAL HOME INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. TIMOTHY CRUMBLEY MS, MHP (CHIEF EXECUTIVE OFFICER)
(706) 681-1991
Entity
Organization
Contact information
Practice address
3575 MACON RD, SUITE 25, COLUMBUS, GA 31907-8200
(706) 940-0478
(706) 940-0479
Mailing address
3575 MACON RD, SUITE 25, COLUMBUS, GA 31907-8200
(706) 940-0478
(706) 940-0479
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/27/2015
Last updated
04/28/2015
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