IndividualActive
Brickney Henry
NPI 1003463449 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Villa Rica, GA
Provider details
- NPI number
- 1003463449
- Entity type
- Individual
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
- Home Health Agency251E00000X
Agencies
- Nursing Care Agency251J00000X
Agencies
- In Home Supportive Care Agency253Z00000X
Agencies
Practice location
652 Nine Oaks Cir
Villa Rica, GA 30180-2533
Phone: (516) 497-8012
Approximate (ZIP-level) locationGet directions
Mailing address
652 Nine Oaks Cir
Villa Rica, GA 30180-2533
Registry dates
- Enumerated
- 2019-08-21
- Last updated
- 2020-12-18
- Certified
- 2020-12-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.