OrganizationActive
Predestined for Greatness
NPI 1154537181 · Emotionally Disturbed Childrens' Residential Treatment Facility · Ellenwood, GA
Provider details
- NPI number
- 1154537181
- Entity type
- Organization
- Primary specialty
- Emotionally Disturbed Childrens' Residential Treatment FacilityResidential Treatment Facilities
- Authorized official
- Dion Thomas, Ceo
- License
- CCI001578 (GA)
Mailing address
4865 Brookstone Pkwy
Ellenwood, GA 30294-2126
Registry dates
- Enumerated
- 2007-05-15
- Last updated
- 2020-08-22
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.