OrganizationActive
Mental Retardation Waiver Program
NPI 1467647875 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Cuthbert, GA
Provider details
- NPI number
- 1467647875
- 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
Practice location
119 Claborn St.
Cuthbert, GA 39840
Phone: (706) 596-5583
Approximate (ZIP-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.