Organization
REPRAH ENTERPRISE,LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
NICOLE HARPER MA (OWNER)
(404) 246-4544
Entity
Organization
Contact information
Practice address
927 GRANITE SPRINGS LN, STONE MOUNTAIN, GA 30083-5102
(404) 246-4544
(404) 755-7609
Mailing address
927 GRANITE SPRINGS LN, STONE MOUNTAIN, GA 30083-5102
(404) 246-4544
(404) 755-7609
Taxonomy
Speciality
Code
Description
License number
State
320700000X
Physical Disabilities Residential Treatment Facility
Primary
044016701
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
044016701
DHR
GA
Enumeration date
11/09/2010
Last updated
07/24/2020
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