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General NPI Number Information
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NPI Number | 1295013720
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Entity Type | Organization
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Legal Business Name | WILTURN SERVICES, LLC
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Dates
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Enumeration Date | 08/02/2011
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Last Update Date | 08/02/2011
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Provider Practice Location Address
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Address Line | 1907 WOLFORD CT
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-3056
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Country | US
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Telephone | 770-935-1511
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Fax | 770-935-1512
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Provider Business Mailing Address
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Address Line | 1907 WOLFORD CT
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City | LAWRENCEVILLE
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State | GA
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Zip | 30043-3056
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Country | US
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Telephone | 770-935-1511
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Fax | 770-935-1512
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Authorized Official
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Title or Position | OWNER
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Name | NANCY WILLIAMS
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Credential |
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Telephone | 678-860-3064
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251S00000X
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Taxonomy Name | Community/Behavioral Health Agency
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License Number |
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License Number State |
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