KELLY TOWN FAMILY GROUP; NPI #1114237567

Contact Information

KELLY TOWN FAMILY GROUP

618 MEDWAY DRIVE
MCDONOUGH, GA 30253

Phone: 678-353-4677
Fax:
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	Community Based Residential Treatment Facility, Mental Illness	320800000X

Indicates primary specialty

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NPI Profile & details for KELLY TOWN FAMILY GROUP

NPI # 1114237567

LBN Legal business name KELLY TOWN FAMILY GROUP

Authorized official TERRIE PETERS - (OWNER)

Entity Organization

Organization subpart ¹ No

Enumeration date 10/19/2010

Last updated 10/19/2010 - About 16 years ago

Identifiers

License #

20100006464

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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KELLY TOWN FAMILY GROUP

Contact Information

Specialty

Community Based Residential Treatment Facility, Mental Illness

NPI Profile & details for KELLY TOWN FAMILY GROUP

Reviews for KELLY TOWN FAMILY GROUP