Organization
CELINE'S FAMILY SERVICE, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SANDRA LEAVELL (EXECUTIVE OFFICER)
(770) 315-5146
Entity
Organization
Contact information
Practice address
6440 OLD HILLANDALE DR, LITHONIA, GA 30058-7672
(770) 315-5146
Mailing address
1417 DOE VALLEY DR, LITHONIA, GA 30058-6203
(770) 315-5146
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
4279373712500
GA
324500000X
Substance Abuse Rehabilitation Facility
4279373712500
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
835780359A
—
GA
Enumeration date
08/28/2007
Last updated
08/28/2007
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