Department of Behavioral Health and Developmental Disabilities

NPI #1053646166 in Gracewood, Georgia

Provider Information

NPI Number
1053646166
Entity Type
Organization
Organization Name
Department of Behavioral Health and Developmental Disabilities
Primary Specialty
Skilled Nursing Facility
Enumeration Date
Oct 7, 2009
Last Updated
May 20, 2015

Practice Location

Address
100 MYRTLE BLVD
State
Georgia
ZIP Code
30812-1500
Phone
(706) 790-2042

Authorized Official

Name
MR. PAUL BROCK
Title
REGIONAL HOSPITAL ADMINISTRATOR
Phone
(706) 790-2030

Specialties & Taxonomy Codes

Specialty
Skilled Nursing Facility

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