Organization
KEB INC
Active
Organization
KEB INC
Active
Other names
HAVENS HOME
Organization subpart
No
Provider details
NPI number
Authorized official
MR. KENNETH EDWARD BAILEY (CEO)
(770) 964-3173
Entity
Organization
Contact information
Practice address
8320 CEDAR GROVE RD, FAIRBURN, GA 30213-2337
(770) 964-3173
Mailing address
8320 CEDAR GROVE RD, FAIRBURN, GA 30213-2337
(770) 964-3173
Taxonomy
Speciality
Code
Description
License number
State
261QD1600X
Developmental Disabilities Clinic/Center
Primary
00882626A
GA
Other
Enumeration date
01/07/2007
Last updated
08/22/2020
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