Organization
INNER HARBOUR, LTD.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
RON SCROGGY (CEO)
(770) 942-2391
Entity
Organization
Contact information
Practice address
8341 GRADY ST, DOUGLASVILLE, GA 30134-6910
(770) 942-2391
Mailing address
4685 DORSETT SHOALS RD, DOUGLASVILLE, GA 30135-4921
(770) 942-2391
Taxonomy
Speciality
Code
Description
License number
State
320800000X
Mental Illness Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
08/23/2007
Last updated
08/23/2007
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