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Organization

CELINE'S FAMILY SERVICE, INC

Active
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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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