Organization
LITTLE DEBBIE'S SECOND CHANCE HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. LAKISHA SHAVON STIGGERS (EXECUTIVE DIRECTOR)
(770) 912-3742
Entity
Organization
Contact information
Practice address
3900 LEPRECHAUN CT, DECATUR, GA 30034-2168
(770) 912-3742
(404) 288-0671
Mailing address
3900 LEPRECHAUN CT, DECATUR, GA 30034-2168
(770) 912-3742
(404) 288-0671
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
—
GA
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
CC1001625
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
585299164A
—
GA
Enumeration date
02/02/2007
Last updated
04/20/2011
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