Georgia Department of Human Resources

NPI #1972670420 in Martinez, Georgia

Provider Information

NPI Number
1972670420
Entity Type
Organization
Organization Name
Georgia Department of Human Resources
Primary Specialty
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Enumeration Date
Nov 29, 2006
Last Updated
Aug 22, 2020

Practice Location

Address
352 PACES FERRY RD
State
Georgia
ZIP Code
30907-9720
Phone
(706) 790-2034

Authorized Official

Name
DR. GAIL C JACKSON, M.D.
Title
REGIONAL HOSPITAL ADMINISTRATOR
Phone
(706) 790-2030

Specialties & Taxonomy Codes

Specialty
Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

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