G Bradley Host Home

NPI #1871863118 in Comer, Georgia

Provider Information

NPI Number
1871863118
Entity Type
Organization
Organization Name
G Bradley 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
517 WATSON MILL RD
City
Comer
State
Georgia
ZIP Code
30629-6124
Phone
(706) 207-0894

Authorized Official

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

Specialties & Taxonomy Codes

Specialty
Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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