Organization · Type 2 NPI
Mental Retardation Waiver Program
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Cuthbert, GA
Practice location
119 Claborn St.
Cuthbert, GA 39840
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 1467647875
Mental Retardation Waiver Program's National Provider Identifier is 1467647875, 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 Cuthbert, GA. The record was last updated on Sep 13, 2007.