Organization
SUMMER STREET COMMUNITY SERVICES, INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACKIE LYNN SHAIN (DIRECTOR)
(503) 949-0531
Entity
Organization
Contact information
Practice address
132 SUMMER ST, ADAIRSVILLE, GA 30103-2958
(770) 773-1904
(770) 773-1904
Mailing address
132 SUMMER ST, ADAIRSVILLE, GA 30103-2958
(770) 773-1904
(770) 773-1904
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
CLA001245
GA
Other
Enumeration date
07/17/2013
Last updated
06/17/2014
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