Organization · Type 2 NPI

Big Mama House

Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Stone Mountain, GA

NPI number 1659752491 Active

Practice location

707 Pennybrook Ln
Stone Mountain, GA 30087-5918

Call (404) 538-6074 Map

Specialties and licenses

TaxonomyCodeLicense
Mental Health Counselor 101YM0800XNone listed
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary 320900000XNone 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.

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About NPI 1659752491

Big Mama House's National Provider Identifier is 1659752491, issued on Jun 17, 2015. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Stone Mountain, GA. The record was last updated on Jun 17, 2015.