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General NPI Number Information
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NPI Number | 1053465492
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Entity Type | Organization
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Legal Business Name | CROSS PLAINS COMMUNITY PARTNER, INC
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Dates
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Enumeration Date | 01/23/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 2738 UNDERWOOD RD NE
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City | DALTON
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State | GA
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Zip | 30721-7471
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Country | US
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Telephone | 706-278-8143
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Fax | 706-272-7648
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Provider Business Mailing Address
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Address Line | 2738 UNDERWOOD RD NE
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City | DALTON
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State | GA
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Zip | 30721-7471
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Country | US
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Telephone | 706-278-8143
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Fax | 706-272-7648
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MRS. DEBORAH CONWAY
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Credential |
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Telephone | 706-278-8143
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number |
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License Number State |
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