Organization · Type 2 NPI
Shane's Crib
Substance Abuse Rehabilitation Facility · Jesup, GA
NPI number
1386035335
Active
Practice location
1303 South 1st Street
Jesup, GA 31545
Fax (912) 385-2583
Mailing address
1303 S 1st St
Jesup, GA 31545-7757
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Substance Abuse Rehabilitation Facility Primary | 324500000X | CSW003662 (GA) |
Substance Abuse Rehabilitation Facility: A facility or distinct part of a facility that provides a 24 hr therapeutically planned living and rehabilitative intervention environment for the treatment of individuals with disorders in the abuse of drugs, alcohol, and other substances.
About NPI 1386035335
Shane's Crib's National Provider Identifier is 1386035335, issued on Feb 12, 2015. The primary taxonomy on file is Substance Abuse Rehabilitation Facility (324500000X), and the practice location is in Jesup, GA. The record was last updated on Feb 12, 2015.