Georgia Department of Human Resources

Organization Active NPI Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Milledgeville, GA

NPI 1154597672 · NPPES record last updated May 5, 2008

Key facts

NPI
1154597672
Entity type
Organization (NPI type 2)
Primary specialty
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X
Legal business name
GEORGIA DEPARTMENT OF HUMAN RESOURCES
Practice address
120 Daphney St SE
Milledgeville, GA 31061-4342
Phone
(478) 445-8182
NPI assigned
May 5, 2008
Organization subpart
No

Authorized official

Name
Mr. George Harris
Title
Director
Phone
(478) 445-8182

Corporate family (same tax ID) 20

Organizations that report the same tax identification number in the National Provider Directory.

National Provider Directory

Tax ID family
Roosevelt Warm SGP Inst (74 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility 320900000X Yes

Addresses

Primary practice location

120 Daphney St SE
Milledgeville, GA 31061-4342

Mailing address

120 Daphney St SE
Milledgeville, GA 31061-4342
Phone (478) 445-8182

Other identifiers

IdentifierTypeStateIssuer
367122367AMedicaidGA

Other names

  • Central Care (120 Daphne St) Doing business as

Other providers in Milledgeville, GA

All providers in Milledgeville, GA · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility in Georgia

Sources for this page

Verify at the official NPI Registry.