Organization
PINKIES PLACE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOSHUA LAMONT PRIMAS (DIRECTOR)
(478) 551-4864
Entity
Organization
Contact information
Practice address
216 SELF ST, WARNER ROBINS, GA 31088-5506
(478) 551-4864
Mailing address
216 SELF ST, WARNER ROBINS, GA 31088-5506
(478) 551-4864
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
09/22/2020
Last updated
09/22/2020
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