Organization · Type 2 NPI
Predestined for Greatness
Emotionally Disturbed Childrens' Residential Treatment Facility · Ellenwood, GA
Practice location
4865 Brookstone Pkwy
Ellenwood, GA 30294-2126
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Emotionally Disturbed Childrens' Residential Treatment Facility Primary | 322D00000X | CCI001578 (GA) |
Emotionally Disturbed Childrens' Residential Treatment Facility: A residential facility that provides habilitation services and other care and treatment to children diagnosed with mental health illness, behavioral issues, and intellectual disabilities and are not able to live independently.
About NPI 1154537181
Predestined for Greatness's National Provider Identifier is 1154537181, issued on May 15, 2007. The primary taxonomy on file is Emotionally Disturbed Childrens' Residential Treatment Facility (322D00000X), and the practice location is in Ellenwood, GA. The record was last updated on Aug 22, 2020.