Organization
SEA BREEZE RETREAT INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MISS NICOLE THEBAUD MS NICOLE THEBAUD (DIRECTOR)
(678) 409-8361
Entity
Organization
Contact information
Practice address
3132 ROBINSON AVE, SCOTTDALE, GA 30079-1526
(678) 409-8361
Mailing address
3132 ROBINSON AVE, SCOTTDALE, GA 30079-1526
(678) 409-8361
Taxonomy
Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
—
GA
Other
Enumeration date
08/15/2012
Last updated
11/15/2024
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