Camp Wanna Be

NPI #1306192737 in Vidalia, Georgia

Provider Information

NPI Number: 1306192737
Entity Type: Organization
Organization Name: Camp Wanna Be
Subpart: Yes (part of a larger organization)
Parent Organization: ALICE BLOUNT ACADEMY OF SCIENCE AND AGRICULTURE
Primary Specialty: Counselor - Professional
Enumeration Date: Aug 3, 2012
Last Updated: Aug 3, 2012

Practice Location

Address: 582 MEL BLOUNT RD
City: Vidalia
State: Georgia
ZIP Code: 30474-9714
Phone: (912) 537-7787

Authorized Official

Name: MR. CLINTON BLOUNT
Title: DIRECTOR
Phone: (912) 537-7787

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Counselor	101Y00000X
Community Based Residential Treatment Facility, Mental Illness	320800000X
Residential Treatment Facility, Emotionally Disturbed Children	322D00000X
Substance Abuse Rehabilitation Facility	324500000X
Substance Abuse Rehabilitation Facility - Substance Abuse Treatment, Children — Substance Abuse Treatment, Children	3245S0500X
Respite Care	385H00000X
Counselor - Professional — Professional	101YP2500X	Primary

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