M Evelyn Host Home

NPI #1851661193 in Monroe, Georgia

Provider Information

NPI Number: 1851661193
Entity Type: Organization
Organization Name: M Evelyn Host Home
Subpart: Yes (part of a larger organization)
Parent Organization: ABHS
Primary Specialty: Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date: Jan 4, 2012
Last Updated: Jan 4, 2012

Practice Location

Address: 1761 RIDGECREST DR
City: Monroe
State: Georgia
ZIP Code: 30655-5273
Phone: (706) 225-1296

Authorized Official

Name: GLENN BUTLER
Title: BILLING MGR
Phone: (706) 389-6789

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320600000X	Primary

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