OrganizationActive
Child, Youth, Adolescents, and Families
NPI 1861861361 · Mental Illness Intermediate Care Facility · Morrow, GA
Provider details
- NPI number
- 1861861361
- Entity type
- Organization
- Primary specialty
- Mental Illness Intermediate Care FacilityNursing & Custodial Care Facilities
- Parent organization
- Behavioral Health Dervices
- Organization subpart
- Yes
- Authorized official
- Elanta Thomas, Registered Nurse(770) 478-2640
- License
- RN228517 (GA)
Specialties & taxonomies
Nursing & Custodial Care Facilities
Practice location
1396 Southlake Plaza Dr
Morrow, GA 30260-1756
Phone: (770) 473-2640
Fax: (770) 473-2601
Approximate (ZIP-level) locationGet directions
Mailing address
1396 Southlake Plaza Dr
Morrow, GA 30260-1756
Registry dates
- Enumerated
- 2015-09-15
- Last updated
- 2015-09-15
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.