MENTAL RETARDATION WAVIER PROGRAM; NPI #1083809040

Contact Information

MENTAL RETARDATION WAVIER PROGRAM

2100 COMER AVE.
COLUMBUS, GA 31904

Phone: 706-596-5583
Fax: 706-596-5589
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities	320900000X

Indicates primary specialty

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NPI Profile & details for MENTAL RETARDATION WAVIER PROGRAM

NPI #	`1083809040`
LBN Legal business name	MENTAL RETARDATION WAVIER PROGRAM
Authorized official	PERRY ALEXANDER - (CEO)
Entity	Organization
Organization subpart ¹	Yes
Enumeration date	09/12/2007
Last updated	09/12/2007 - About 19 years ago
Identifiers	n/a

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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MENTAL RETARDATION WAVIER PROGRAM

Contact Information

Specialty

Community Based Residential Treatment Facility, Intellectual and/or Developmental Disabilities

NPI Profile & details for MENTAL RETARDATION WAVIER PROGRAM

Reviews for MENTAL RETARDATION WAVIER PROGRAM