Organization · Type 2 NPI

Mental Retardation Wavier Program

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Columbus, GA

NPI number 1083809040 Active

Practice location

2100 Comer Ave.
Columbus, GA 31904

Call (706) 596-5583 Map

Fax (706) 596-5589

Mailing address

1325 Sandusky Dr
Columbus, GA 31907-3964

Specialties and licenses

TaxonomyCodeLicense
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000XNone listed

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility: A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with intellectual and/or developmental disabilities.

2 other providers at this address

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About NPI 1083809040

Mental Retardation Wavier Program's National Provider Identifier is 1083809040, issued on Sep 12, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Columbus, GA. The record was last updated on Sep 12, 2007.