Carmela Smith Gray Host Home

NPI #1164767182 in Bethlehem, Georgia

Provider Information

NPI Number: 1164767182
Entity Type: Organization
Organization Name: Carmela Smith Gray Host Home
Subpart: Yes (part of a larger organization)
Parent Organization: ABHS
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Dec 3, 2012
Last Updated: Dec 3, 2012

Practice Location

Address: 149 THORN BROOK RD
City: Bethlehem
State: Georgia
ZIP Code: 30620-2405
Phone: (706) 389-6789

Authorized Official

Name: GLENN BUTLER
Title: BILLING MGR
Phone: (706) 389-6789

Specialties & Taxonomy Codes

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

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