Organization
SEA JOY FAMILY SERVICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ERICA WATFORD (EXECUTIVE DIRECTOR)
(770) 374-7268
Entity
Organization
Contact information
Practice address
2851 CANDLER RD, SUITE 205, DECATUR, GA 30034-1416
(770) 374-7268
Mailing address
2851 CANDLER RD, SUITE 205, DECATUR, GA 30034-1416
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
926894182A
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
926894182A
—
GA
Enumeration date
10/22/2009
Last updated
10/22/2009
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