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General NPI Number Information
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NPI Number | 1124201561
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Entity Type | Organization
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Legal Business Name | YOUR FRIENDS AND NEIGHBORS OF GA, INC
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Dates
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Enumeration Date | 12/07/2007
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Last Update Date | 12/07/2007
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Provider Practice Location Address
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Address Line | 2358 PERIMETER PARK DR SUITE 320
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City | ATLANTA
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State | GA
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Zip | 30341-1332
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Country | US
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Telephone | 770-641-8300
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Fax | 770-645-8666
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Provider Business Mailing Address
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Address Line | 1515 MAGNAVOX WAY
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City | FORT WAYNE
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State | IN
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Zip | 46804-1533
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Country | US
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Telephone | 260-459-1551
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Fax | 260-459-1451
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Authorized Official
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Title or Position | CEO
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Name | MS. PAMELA BEAL
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Credential |
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Telephone | 770-641-8300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320600000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Residential Treatment Facility
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License Number |
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License Number State |
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