Mount Eagles Wings INC

NPI #1104182864 in Martinez, Georgia

Provider Information

NPI Number: 1104182864
Entity Type: Organization
Organization Name: Mount Eagles Wings INC
Primary Specialty: Clinic/Center - Developmental Disabilities
Enumeration Date: Apr 7, 2012
Last Updated: Apr 7, 2012

Practice Location

Address: 4027 PRESCOTT DR
City: Martinez
State: Georgia
ZIP Code: 30907-4308
Phone: (706) 284-9959

Authorized Official

Name: MS. VENNA SHARELL REESE, HEATHCARE PROVIDER
Title: CEO/ADMINISTRATOR
Phone: (706) 284-9959

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Clinic/Center - Developmental Disabilities — Developmental Disabilities	261QD1600X	Primary

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