| Southern Group Homes, Llc | |
|
5450 Platte Dr Ellenwood GA 30294-6667 | |
| (770) 472-9113 | |
| Not Available |
| Full Name | Southern Group Homes, Llc |
|---|---|
| Speciality | Community/behavioral Health |
| Location | 5450 Platte Dr, Ellenwood, Georgia |
| Authorized Official Name and Position | Jeffrey Charles Chastain (OWNER) |
| Authorized Official Contact | 8649795397 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Southern Group Homes, Llc Po Box 228 Easley SC 29641-0228 Ph: (770) 472-9113 | Southern Group Homes, Llc 5450 Platte Dr Ellenwood GA 30294-6667 Ph: (770) 472-9113 |
| NPI Number | 1033424171 |
|---|---|
| Provider Enumeration Date | 08/13/2010 |
| Last Update Date | 08/13/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033424171 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 251S00000X | Community/behavioral Health | (* (Not Available)) | Primary |
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