Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. TYLER ROSE
Active Sole ProprietorIntellectual Disabilities Residential Treatment Facility · WOODSTOCK, GA
Registration Details
- NPI Number
- 1730715814
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Mar 20, 2020 (6.0895362630289 yrs)
- Last Updated
- Mar 20, 2020
- Sole Proprietor
- Yes
Practice Information
- Address
-
116 SOUTH MILL CREEK COURTWOODSTOCK, GA, 30188Browse GA providers · Browse ZIP 30188
- Phone
- 6783494071
- Primary Specialty
-
Intellectual Disabilities Residential Treatment Facility
320600000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.