Individual provider · Type 1 NPI
Amber Blaine Nicholson
Mental Illness Community Based Residential Treatment Facility · Carrollton, GA
NPI number
1609790013
Active
Practice location
309 Matthews Ave
Carrollton, GA 30117-3629
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Substance Abuse Rehabilitation Facility | 324500000X | None listed |
| Psychiatric Residential Treatment Facility | 323P00000X | None listed |
| Mental Illness Community Based Residential Treatment Facility Primary | 320800000X | None listed |
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility | 320900000X | None listed |
| Respite Care | 385H00000X | None listed |
Mental Illness Community Based Residential Treatment Facility: A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
Another provider at this address
About NPI 1609790013
Amber Blaine Nicholson's National Provider Identifier is 1609790013, issued on Aug 7, 2026. The primary taxonomy on file is Mental Illness Community Based Residential Treatment Facility (320800000X), and the practice location is in Carrollton, GA. The record was last updated on Aug 17, 2026.