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Individual

TIFFANY A TOWNS

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2843 RIDGEVIEW DR, AUGUSTA, GA 30909-9641
(706) 432-7893
(706) 432-3780
Mailing address
3421 MIKE PADGETT HWY, AUGUSTA, GA 30906-3815
(706) 432-7893
(706) 432-3780

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000927693AR
GA
Enumeration date
09/16/2011
Last updated
07/02/2013
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