T Leige Host Home

NPI 1205106549 - Residential Treatment Facility, Mental Retardation and/or Developmental Disabilities - 320600000X

NPI Details
NPI 1205106549
Enumeration Date 01/04/2012
Last Updated 01/04/2012
Entity Type Healthcare Provider
Active Over 4 years ago
Authorized Information
Name GLENN GLENN
Position BILLING MGR
Phone (706) 340-7421
Fax
Practice Location
202 SWEETGUM WAY
ATHENS GA, 30601-4067, US
Phone (706) 340-7421
Fax
Business Location
250 NORTH AVE
ATHENS GA, 30601-2244, US
Phone (706) 389-6789
Fax
Toxanomy
Taxonomy Code 320600000X
License State
License Number
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According to our database, T Leige Host Home NPI is 1205106549, taxonomy code is 320600000X T Leige Host Home physically located at 202 Sweetgum Way, Athens GA, 30601-4067. NPI Number 1033115704 has the healthcare provider type.

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1205106549 NPI number is provided on an as is basis without warranty of any kind. 1205106549 is maintained by the National Plan & Provider Enumeration System. The contents of T Leige Host Home are for informational purposes only.