Hickory Log Vocational School INC

NPI #1790385862 in White, Georgia

Provider Information

NPI Number: 1790385862
Entity Type: Organization
Organization Name: Hickory Log Vocational School INC
Primary Specialty: Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Oct 28, 2020
Last Updated: Oct 28, 2020

Practice Location

Address: 3680 HIGHWAY 411 NE
City: White
State: Georgia
ZIP Code: 30184-2427
Phone: (770) 382-6655

Authorized Official

Name: KEVIN BRIAN BARNES, REV,DR
Title: EXECUTIVE DIRECTOR
Phone: (770) 382-6655

Specialties & Taxonomy Codes

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

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