Organization Name: | CELESTIAL CARE SERVICES, INC |
NPI Number: | 1356642334 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | CELESTINE B HARRIS (CEO) |
Mailing Address: | 6571 Valley Hill Dr Sw Mableton |
State: | GA US |
Postal Code: | 301265151 |
Phone Number: | 7709480709 |
Fax Number: | 7709483109 |
NPI Enumeration Date: | 11/08/2010 |
NPI Last Update Date: | 11/08/2010 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 320900000X |
License Number: | 033011031 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | GA |
Taxonomy Type: | Residential Treatment Facilities |
Taxonomy Classification: | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities |
Taxonomy Specialization: | |
Taxonomy Definition: | A home-like residential facility providing habilitation, support and monitoring services to individuals diagnosed with mental retardation and/or developmental disabilities. |