OrganizationActive
Mental Retardation Wavier Program
NPI 1376738781 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Hamilton, GA
Provider details
- NPI number
- 1376738781
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Perry Alexander, Ceo(706) 596-5582
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000X
Residential Treatment Facilities
Profile Score
Detailed profile(88/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
18 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
9993 Ga Highway 116
Hamilton, GA 31811
Phone: (706) 596-5583
Fax: (706) 596-5589
Street-level locationGet directions
Mailing address
2100 Comer Ave
Columbus, GA 31904-8725
Registry dates
- Enumerated
- 2007-09-10
- Last updated
- 2007-09-13
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.