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General NPI Number Information
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NPI Number | 1235490095
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Entity Type | Organization
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Legal Business Name | APFA
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Dates
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Enumeration Date | 06/07/2012
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Last Update Date | 06/07/2012
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Provider Practice Location Address
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Address Line | 4776 BEN HILL RD
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-4213
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Country | US
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Telephone | 770-401-8028
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Fax | 770-401-8028
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Provider Business Mailing Address
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Address Line | 4776 BEN HILL RD
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City | DOUGLASVILLE
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State | GA
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Zip | 30134-4213
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Country | US
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Telephone | 770-401-8028
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Fax | 770-401-8028
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Authorized Official
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Title or Position | CEO
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Name | MS. JANET BECK
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Credential |
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Telephone | 770-401-8028
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320700000X
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Taxonomy Name | Physical Disabilities Residential Treatment Facility
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License Number | PCH0007146
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License Number State | GA
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Taxonomy #2
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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 | PCH0007146
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License Number State | GA
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