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General NPI Number Information
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NPI Number | 1376815878
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Entity Type | Organization
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Legal Business Name | L BATTLO, LLC
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Dates
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Enumeration Date | 01/31/2012
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Last Update Date | 01/31/2012
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Provider Practice Location Address
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Address Line | 3550 KEELS LN
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City | ATLANTA
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State | GA
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Zip | 30349-4546
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Country | US
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Telephone | 770-969-6513
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Fax | 770-471-6592
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Provider Business Mailing Address
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Address Line | 7995 WOODS LN
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City | JONESBORO
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State | GA
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Zip | 30236-3976
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Country | US
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Telephone | 404-944-1501
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Fax | 770-471-6592
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | MRS. VALERIE L BATTLES
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Credential |
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Telephone | 404-944-1501
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 320900000X
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Taxonomy Name | Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility
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License Number |
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License Number State | GA
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