Organization
CHANGING LIVES TODAY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. ALVIN LAMAR TERRELL BACHELOR OF SCIENCE (PRESIDENT)
(678) 365-8349
Entity
Organization
Contact information
Practice address
3240 ANCOATS ST, DOUGLASVILLE, GA 30135-8199
(678) 365-8349
Mailing address
3240 ANCOATS ST, DOUGLASVILLE, GA 30135-8199
(678) 365-8349
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
—
—
Other
Enumeration date
12/18/2012
Last updated
12/18/2012
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