Organization
SERVING ONE OF US
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SHIRLEY WALKER WORTHY (OWNER/DIRECTOR/ADMINISTRATOR)
(404) 428-2749
Entity
Organization
Contact information
Practice address
1544 WELLBORN RD, #3, LITHONIA, GA 30058-5492
(404) 428-2749
(770) 786-0499
Mailing address
1544 WELLBORN RD, #3, LITHONIA, GA 30058-5492
(404) 428-2749
(770) 786-0499
Taxonomy
Speciality
Code
Description
License number
State
251C00000X
Developmentally Disabled Services Day Training Agency
Primary
600242281A
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
600242281A
—
GA
Enumeration date
09/04/2010
Last updated
09/04/2010
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