Organization
RACHAM FOUNDATION, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNY BLEVINS (ADMINSTRATOR)
(770) 489-1819
Entity
Organization
Contact information
Practice address
6496 CEDAR MOUNTAIN RD, DOUGLASVILLE, GA 30134-3505
(770) 489-1819
(770) 489-7316
Mailing address
6496 CEDAR MOUNTAIN RD, DOUGLASVILLE, GA 30134-3505
(770) 489-1819
(770) 489-7316
Taxonomy
Speciality
Code
Description
License number
State
320600000X
Intellectual and/or Developmental Disabilities Residential Treatment Facility
Primary
—
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00945117B
—
GA
05
—
00945117C
—
GA
05
—
00945117D
—
GA
Enumeration date
04/11/2007
Last updated
08/22/2020
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