Organization
ATLEMISIA ANDERSON
Active
Other names
we carw
Organization subpart
No
Provider details
NPI number
Authorized official
ATLEMISIA M ANDERSON (OWNER)
(229) 379-1007
Entity
Organization
Contact information
Practice address
416 GLEN ARVEN DR, THOMASVILLE, GA 31792-6837
(229) 379-1007
Mailing address
117 WILLOW RIDGE CIR, THOMASVILLE, GA 31757-2834
(229) 379-1007
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
—
320800000X
Mental Illness Community Based Residential Treatment Facility
—
—
Other
Enumeration date
11/03/2010
Last updated
11/03/2010
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