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DEPARTMENT OF BEHAVIORAL HEALTH & DEV. DISABILITIES

Intermediate Care Facility, Mentally Retarded

Thomasville, Georgia

Provider NPI: 1720071947

Organization Information:
Organization Name:  DEPARTMENT OF BEHAVIORAL HEALTH & DEV. DISABILITIES


Practice Location:
400 S PINETREE BLVD  THOMASVILLE, GA 31792 US
Tel: 229-227-3004  Fax: --

Business Mailing Address:
  ,   
Tel: --  Fax: --


Taxonomy:

PrimaryCodeCategory/DescriptionStateLicense Number
Y315P00000XNursing & Custodial Care Facilities
Intermediate Care Facility, Mentally Retarded
GA2-136-1643

Other Provider Identifiers:

IssuerNumberStateType
00190484AGA05
Code values:
01, Other | 02, Medicare Upin | 04, Medicare Id-Type Unspecified
05, Medicaid | 06, Medicare Oscar/Certification | 07, Medicare NSC | 08, Medicare Pin




MENTALLY RETARDED JOBS GA - Page 1



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