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General NPI Number Information
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NPI Number | 1720428717
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Entity Type | Organization
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Legal Business Name | FIRST OPTION SERVICES
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Dates
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Enumeration Date | 07/05/2013
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Last Update Date | 07/05/2013
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Provider Practice Location Address
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Address Line | 928 HIGHWAY 314
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-3404
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Country | US
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Telephone | 678-327-6878
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Fax |
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Provider Business Mailing Address
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Address Line | 928 HIGHWAY 314
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City | FAYETTEVILLE
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State | GA
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Zip | 30214-3404
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Country | US
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Telephone | 678-327-6878
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Fax |
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Authorized Official
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Title or Position | OWNER/DIRECTOR
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Name | JACQUELINE HENRY RAINFORD
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Credential |
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Telephone | 678-327-6878
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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 | 056010222
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License Number State | GA
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