OrganizationActive
Exquisite Traditions
NPI 1558657494 · Intellectual and/or Developmental Disabilities Community Based Residential Treatment Facility · Jonesboro, GA
Provider details
- NPI number
- 1558657494
- Entity type
- Organization
- Primary specialty
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityResidential Treatment Facilities
- Organization subpart
- No
- Authorized official
- Kyle Ballif, Ceo(404) 525-9500
- License
- PCH001261 (GA)
Specialties & taxonomies
- Intellectual and/or Developmental Disabilities Community Based Residential Treatment FacilityPrimary320900000XLicense PCH001261 (GA)
Residential Treatment Facilities
Residential Treatment Facilities
Practice location
7265 Mount Zion Blvd
Jonesboro, GA 30236-2519
Phone: (404) 525-9500
Fax: (404) 393-9436
Approximate (ZIP-level) locationGet directions
Mailing address
2045 Mount Zion Rd
Morrow, GA 30260-3313
Registry dates
- Enumerated
- 2011-06-20
- Last updated
- 2011-06-20
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.