Organization · Type 2 NPI
Mental Retardation Wavier Program
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Hamilton, GA
Practice location
9993 Ga Highway 116
Hamilton, GA 31811
Fax (706) 596-5589
Mailing address
2100 Comer Ave
Columbus, GA 31904-8725
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 1376738781
Mental Retardation Wavier Program's National Provider Identifier is 1376738781, issued on Sep 10, 2007. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Hamilton, GA. The record was last updated on Sep 13, 2007.