Household of Faith

NPI #1174868707 in Jackson, Georgia

Provider Information

NPI Number
1174868707
Entity Type
Organization
Organization Name
Household of Faith
Subpart
Yes (part of a larger organization)
Parent Organization
HOUSEHOLD OF FAITH
Primary Specialty
Preferred Provider Organization
Enumeration Date
Dec 7, 2012
Last Updated
Dec 8, 2012

Practice Location

Address
341 OLD GRIFFIN RD
State
Georgia
ZIP Code
30233-4952
Phone
(678) 774-8033

Authorized Official

Name
MRS. ANGELA MILLER
Title
EXCUTIVE DIRECTOR
Phone
(678) 774-8033

Specialties & Taxonomy Codes

Specialty
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Preferred Provider Organization

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