OrganizationActive
Carmela Smith Gray Host Home
NPI 1164767182 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Bethlehem, GA
Provider details
- NPI number
- 1164767182
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Parent organization
- Abhs
- Organization subpart
- Yes
- Authorized official
- Glenn Butler, Billing Mgr(706) 389-6789
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Practice location
149 Thorn Brook Rd
Bethlehem, GA 30620-2405
Phone: (706) 389-6789
Approximate (ZIP-level) locationGet directions
Mailing address
250 North Ave
Athens, GA 30601-2244
Registry dates
- Enumerated
- 2012-12-03
- Last updated
- 2012-12-03
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.