Providence Residential & Outpatient Ptsd Services (props)
NPI #1336480201 in Douglasville, Georgia
Provider Information
- NPI Number
- 1336480201
- Entity Type
- Organization
- Organization Name
- Providence Residential & Outpatient Ptsd Services (props)
- Primary Specialty
- Community Based Residential Treatment Facility, Mental Illness
- Enumeration Date
- Mar 1, 2013
- Last Updated
- Mar 1, 2013
Practice Location
- Address
- 3400 CHAPEL HILL RD
- Address 2
- SUITE 100 PMB #08
- City
- Douglasville
- State
- Georgia
- ZIP Code
- 30135-1739
- Phone
- (678) 882-5371
Authorized Official
- Name
- DR. FELICIA BERRY-MITCHELL, PHD
- Title
- PRESIDENT
- Phone
- (678) 882-5371
Specialties & Taxonomy Codes
| Specialty |
|---|
| Community Based Residential Treatment Facility, Mental Illness |
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