Organization
TAMMY HEARD HOST HOME
Active
Organization subpart
No
Provider details
NPI number
Authorized official
GLENN BUTLER (BILLING MGR)
(706) 389-6789
Entity
Organization
Contact information
Practice address
115 UPSHAW DR, ELBERTON, GA 30635
(706) 389-6789
Mailing address
250 NORTH AVE, ATHENS, GA 30601-2244
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
—
Other
Enumeration date
02/25/2013
Last updated
02/25/2013
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