Dade Community Living Arrangement (cla)

NPI #1780953018 in Oxford, Georgia

Provider Information

NPI Number: 1780953018
Entity Type: Organization
Organization Name: Dade Community Living Arrangement (cla)
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Dec 15, 2011
Last Updated: Dec 15, 2011

Practice Location

Address: 1289 MACEDONIA CHURCH RD.
City: Oxford
State: Georgia
ZIP Code: 30054-3651
Phone: (678) 660-3339

Authorized Official

Name: MRS. DIAN EVADNE WALTERS-MOTT
Title: OWNER/DIRECTOR
Phone: (678) 768-5997

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Nursing Home Administrator	376G00000X
Nurse's Aide	376K00000X
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X	Primary

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