Organization
DPCH, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PHILIP DEMBURE (CHIEF OPERATING OFFICER)
(404) 761-2508
Entity
Organization
Contact information
Practice address
4818 OLD NATIONAL HWY, COLLEGE PARK, GA 30337-6233
(404) 761-2508
(404) 761-2644
Mailing address
4818 OLD NATIONAL HWY, COLLEGE PARK, GA 30337-6233
(404) 761-2644
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
—
GA
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000891591A
—
GA
05
—
000891591B
—
GA
Enumeration date
04/18/2007
Last updated
06/24/2008
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