Georgia Department of Human Resources

NPI #1265509806 in Hephzibah, Georgia

Provider Information

NPI Number: 1265509806
Entity Type: Organization
Organization Name: Georgia Department of Human Resources
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Nov 29, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 4114 PINNACLE PINES CT
City: Hephzibah
State: Georgia
ZIP Code: 30815-6137
Phone: (706) 790-2034

Authorized Official

Name: DR. GAIL C JACKSON, M.D.
Title: REGIONAL HOSPITAL ADMINISTRATOR
Phone: (706) 790-2030

Specialties & Taxonomy Codes

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

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