Mental Retardation Wavier Program

NPI #1083809040 in Columbus, Georgia

Provider Information

NPI Number: 1083809040
Entity Type: Organization
Organization Name: Mental Retardation Wavier Program
Subpart: Yes (part of a larger organization)
Parent Organization: NEW HORIZONS COMMUNITY SERVICE BOARD
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Sep 12, 2007
Last Updated: Sep 12, 2007

Practice Location

Address: 2100 COMER AVE.
City: Columbus
State: Georgia
ZIP Code: 31904
Phone: (706) 596-5583

Authorized Official

Name: PERRY ALEXANDER
Title: CEO
Phone: (706) 596-5582

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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Skiy Mitchell, LAPC, CACI, NBCC	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	Columbus	AI Deep Dive
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Organizations

Provider Name	Specialty	City
Mental Retardation Wavier Program Part of New Horizons Community Service Board	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	Columbus	AI Deep Dive
Department of Behavioral Health and Developmental Disabilities	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	Columbus	AI Deep Dive
Department of Behavioral Health and Developmental Disabilities	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	Columbus	AI Deep Dive

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