OrganizationActive
Allegiant Service LLC
NPI 1316279557 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Decatur, GA
Provider details
- NPI number
- 1316279557
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Mary Ferguson, Administrator(678) 491-6215
- License
- 126168557A (GA)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense 126168557A (GA)
Residential Treatment Facilities
Practice location
4323 Juneberry Ct
Decatur, GA 30034-6425
Phone: (678) 491-6215
Fax: (770) 558-1580
Approximate (ZIP-level) locationGet directions
Mailing address
4323 Juneberry Ct
Decatur, GA 30034-6425
Registry dates
- Enumerated
- 2010-02-12
- Last updated
- 2010-02-12
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.