Organization
PAUL ANDERSON YOUTH HOME, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BETTY C. BURRIS MA (PROGRAM DIRECTOR)
(912) 537-7237
Entity
Organization
Contact information
Practice address
1603 MCINTOSH STREET, VIDALIA, GA 30474
(912) 537-7237
(912) 537-8734
Mailing address
PO BOX 525, VIDALIA, GA 30475-0525
(912) 537-7237
Taxonomy
Speciality
Code
Description
License number
State
322D00000X
Emotionally Disturbed Childrens' Residential Treatment Facility
Primary
—
—
324500000X
Substance Abuse Rehabilitation Facility
—
—
Other
Enumeration date
06/18/2013
Last updated
06/18/2013
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