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Organization

CLAIRE CUSTOM CARE

Active
Organization subpart
No

Provider details

NPI number
Authorized official
SANDRA ANGEUS (CEO)
(678) 233-8285
Entity
Organization

Contact information

Practice address
1452 TETHER LN, MCDONOUGH, GA 30253-9210
(678) 233-8285
(844) 273-5942
Mailing address
1452 TETHER LN, MCDONOUGH, GA 30253-9210
(678) 233-8285
(844) 273-5942

Taxonomy

Speciality
Code
Description
License number
State
320900000X
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
Primary
GA

Other

Enumeration date
10/23/2014
Last updated
10/23/2014
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