Organization
TUDOR CASTLE COMMUNITY HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE FOSTER-RICE (ADMINISTRATOR)
(404) 243-2353
Entity
Organization
Contact information
Practice address
2056 TUDOR CASTLE CIR, DECATUR, GA 30035-2154
(678) 518-9280
Mailing address
2056 TUDOR CASTLE CIR, DECATUR, GA 30035-2154
(678) 518-9280
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
044232
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00954324F
—
GA
Enumeration date
12/27/2006
Last updated
08/22/2020
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