Sid's Place Incorporated
NPI #1174823595 in Ellenwood, Georgia
Provider Information
- NPI Number
- 1174823595
- Entity Type
- Organization
- Organization Name
- Sid's Place Incorporated
- Primary Specialty
- Assisted Living Facility
- Enumeration Date
- Nov 1, 2010
- Last Updated
- Nov 1, 2010
Practice Location
Authorized Official
- Name
- MR. ZANNIE DARRELL BLACK
- Title
- OWNER
- Phone
- (678) 557-8969
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Mental Illness |
| Assisted Living Facility |
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