Organization
GA DEPARTMENT OF JUVENILE JUSTICE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SANDRA DEATON (FEDERAL PROGRAMS DIRECTOR)
(404) 508-6610
Entity
Organization
Contact information
Practice address
3408 COVINGTON HWY, DECATUR, GA 30032-1513
(404) 508-6610
(404) 508-5091
Mailing address
3408 COVINGTON HWY, DECATUR, GA 30032-1513
(404) 508-6610
(404) 508-5091
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
—
—
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/02/2007
Last updated
09/11/2025
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