Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
PREDESTINED FOR GREATNESS
Active OrganizationResidential Treatment, Emotionally Disturbed Children · ELLENWOOD, GA
Registration Details
- NPI Number
- 1154537181
- Provider Type
- Organization
- NPI Issued
- May 15, 2007 (18.941129315141 yrs)
- Last Updated
- Aug 22, 2020
- License
-
CCI001578 (GA)
Practice Information
- Address
-
4865 BROOKSTONE PKWYELLENWOOD, GA, 302942126Browse GA providers · Browse ZIP 30294
- Phone
- 7703209278
- Primary Specialty
-
Residential Treatment, Emotionally Disturbed Children
322D00000X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.