Individual provider · Type 1 NPI
Alice Gath
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Picayune, MS
Practice location
1003 E Sycamore Rd
Picayune, MS 39466-2700
Other practice locations
- 1003 E Sycamore Rd, Picayune, MS 39466-2700 · (601) 569-0872
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | None 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.
About NPI 1376117986
Alice Gath's National Provider Identifier is 1376117986, issued on May 18, 2021. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Picayune, MS. The record was last updated on May 18, 2021.