OrganizationActive
Early Miller Personal Support (now)
NPI 1710255773 · Developmental Disabilities Clinic/Center · Blakely, GA
Provider details
- NPI number
- 1710255773
- Entity type
- Organization
- Primary specialty
- Developmental Disabilities Clinic/CenterAmbulatory Health Care Facilities
- Organization subpart
- No
- Authorized official
- David Baranko, Cfo(229) 430-0416
Specialties & taxonomies
Ambulatory Health Care Facilities
Practice location
302 Damascus Street
Blakely, GA 39823-3346
Phone: (229) 723-4325
Approximate (ZIP-level) locationGet directions
Mailing address
302 Damascus Street
Blakely, GA 39823-3346
Registry dates
- Enumerated
- 2011-12-06
- Last updated
- 2011-12-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.