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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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