Organization
FRIENDS OF COASTAL GA LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MARANDA LEAH PORTER BCBA (OWNER BEHAVIOR ANALYST)
(888) 508-1012
Entity
Organization
Contact information
Practice address
528 GOLDEN GROVE LN, RICHMOND HILL, GA 31324-5908
(888) 508-1012
(888) 558-9897
Mailing address
528 GOLDEN GROVE LN, RICHMOND HILL, GA 31324-5908
(888) 508-1012
(888) 558-9897
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
05/04/2022
Last updated
05/04/2022
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