Organization
CHANCE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SHARON G REEVES (OWNER)
(770) 227-1404
Entity
Organization
Contact information
Practice address
1945 N 2ND. ST. EXT., GRIFFIN, GA 30223
(770) 227-1404
Mailing address
1645 N 2ND. ST. EXT., GRIFFIN, GA 30223
(770) 227-1404
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
320800000X
GA
Other
Enumeration date
09/08/2010
Last updated
09/08/2010
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