| Harvestlodge Homes And Services For Children And Families | |
|
4187 Connor Dr. Ellenwood GA 30294 | |
| (770) 981-2903 | |
| (770) 808-6648 |
| Full Name | Harvestlodge Homes And Services For Children And Families |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 4187 Connor Dr., Ellenwood, Georgia |
| Authorized Official Name and Position | Dannetta B Sparks (CEO/DIRECTOR) |
| Authorized Official Contact | 7709812903 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Harvestlodge Homes And Services For Children And Families 3467 Hunters Hill Dr Lithonia GA 30038-1614 Ph: (770) 981-2903 | Harvestlodge Homes And Services For Children And Families 4187 Connor Dr. Ellenwood GA 30294 Ph: (770) 981-2903 |
| NPI Number | 1467645044 |
|---|---|
| Provider Enumeration Date | 08/27/2007 |
| Last Update Date | 08/27/2007 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1467645044 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (Georgia) | Primary |
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