Juanita Appling

Individual provider Active NPI Intellectual and/or Developmental Disabilities Residential Treatment Facility · Thomson, GA

NPI 1932590171 · NPPES record last updated Mar 18, 2015

Key facts

NPI
1932590171
Entity type
Individual (NPI type 1)
Primary specialty
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X
Practice address
2857 Sallywhite Rd
Thomson, GA 30824-6903
Phone
(706) 825-6482
Fax
(706) 595-5970
NPI assigned
Feb 10, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual and/or Developmental Disabilities Residential Treatment Facility 320600000X Yes

Addresses

Primary practice location

2857 Sallywhite Rd
Thomson, GA 30824-6903

Mailing address

2857 Sallywhite Rd
Thomson, GA 30824-6903
Phone (706) 825-6482

Other providers in Thomson, GA

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

Sources for this page

Verify at the official NPI Registry.