Organization
HARVESTLODGE HOMES AND SERVICES FOR CHILDREN AND FAMILIES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DANNETTA B SPARKS PH.D. (CEO/DIRECTOR)
(770) 981-2903
Entity
Organization
Contact information
Practice address
4187 CONNOR DR., ELLENWOOD, GA 30294
(770) 981-2903
(770) 808-6648
Mailing address
3467 HUNTERS HILL DR, LITHONIA, GA 30038-1614
(770) 981-2903
(770) 808-6648
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
GA
Other
Enumeration date
08/27/2007
Last updated
08/27/2007
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