Organization
OWLS RETREAT INC.
Active
Organization
OWLS RETREAT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. ONETHIA LOGAN (OWNER/DIRECTOR)
(404) 288-4782
Entity
Organization
Contact information
Practice address
2858 SANTA BARBARA DR, DECATUR, GA 30032-3552
(404) 288-4782
Mailing address
2858 SANTA BARBARA DR, DECATUR, GA 30032-3552
(404) 288-4782
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000888511B
—
GA
Enumeration date
07/02/2010
Last updated
07/02/2010
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