Organization
BOBBY BENNETT HOST HOME
Active
Parent organization
SATILLA COMMUNITY SERVICES
Other names
Satilla Community Services
Organization subpart
Yes
Provider details
NPI number
Legal business name
SATILLA COMMUNITY SERVICES
Authorized official
GLYNN THOMAS PHD (CEO)
(912) 449-7103
Entity
Organization
Contact information
Practice address
1007 MARY ST, WAYCROSS, GA 31503-3823
(912) 449-7111
Mailing address
4156 WHITE TAIL WAY, BLACKSHEAR, GA 31516-5204
(912) 449-8601
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
04/15/2010
Last updated
04/15/2010
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