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Altomese Neloms Host Home

Residential Treatment Facility, Intellectual and/or Developmental Disabilities in Waycross, GA. Organization (NPI-2).

NPI number1669922332
StatusActive
Last updated in NPPESOct 6, 2016

Details

NPI
1669922332
Entity type
Organization (NPI-2)
Legal business name
Altomese Neloms Host Home
Organization subpart
No
Enumeration date
Oct 6, 2016
Last updated
Oct 6, 2016

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
320600000X Residential Treatment Facility, Intellectual and/or Developmental Disabilities––Yes

Practice location

1007 Mary St
Waycross, GA 31503-3823

Phone 912-449-7109

Mailing address

1314 Elizabeth St
Waycross, GA 31503-3935

Authorized official

Michelle Simpson
Billing Manager
9124497109

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Other Intellectual and/or Developmental Disabilities Residential Treatment Facility providers in Waycross, GA

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