| Magnolia Gardens Pch, Inc | |
|
5348 Kelleys Creek Dr Stone Mountain GA 30088-3827 | |
| (770) 469-8925 | |
| (770) 469-8925 |
| Full Name | Magnolia Gardens Pch, Inc |
|---|---|
| Speciality | Community Based Residential Treatment Facility, Intellectual And/or Developmental Disabilities |
| Location | 5348 Kelleys Creek Dr, Stone Mountain, Georgia |
| Authorized Official Name and Position | Teri D. Cargill (DIRECTOR) |
| Authorized Official Contact | 6786970575 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Magnolia Gardens Pch, Inc Po Box 684 Lovejoy GA 30250-0684 Ph: (770) 469-8925 | Magnolia Gardens Pch, Inc 5348 Kelleys Creek Dr Stone Mountain GA 30088-3827 Ph: (770) 469-8925 |
| NPI Number | 1912138454 |
|---|---|
| Provider Enumeration Date | 07/31/2009 |
| Last Update Date | 03/12/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1912138454 | NPI | - | NPPES |
| 256949895B | Medicaid | GA |
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