National Provider Identifier Database

KELLY TOWN FAMILY GROUP
Community Based Residential Treatment Facility, Mental Illness

A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.


Contact Information

KELLY TOWN FAMILY GROUP
618 MEDWAY DRIVE
MCDONOUGH, GA30253
Phone: 678-353-4677
Fax:
Website:
Specialty Taxonomy Code
* Community Based Residential Treatment Facility, Mental Illness 320800000X

* Indicates primary specialty

NPI Profile & details for KELLY TOWN FAMILY GROUP

NPI Number 1114237567
Legal business name
LBN
KELLY TOWN FAMILY GROUP
Authorized official TERRIE PETERS - (OWNER)
Entity Organization
Organization subpart No
Enumeration date 10/19/2010
Last updated 10/19/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • AL License #: 20100006464

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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