Individual provider · Type 1 NPI
Tracy Marshall
Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Woodstock, GA
Practice location
255 Grimes Rd
Woodstock, GA 30188-6725
Fax (678) 366-6051
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility Primary | 320900000X | 320900000X (GA) |
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.
Another provider at this address
About NPI 1942665567
Tracy Marshall's National Provider Identifier is 1942665567, issued on Dec 25, 2015. The primary taxonomy on file is Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility (320900000X), and the practice location is in Woodstock, GA. The record was last updated on Dec 25, 2015.