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Earlean Blackwell
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Marietta, Georgia
NPI 1023677713

Earlean Blackwell is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Marietta, GA. Earlean Blackwell practices in Marietta, GA. The NPI Number for Earlean Blackwell is 1023677713 and holds a License No. (Georgia).

The current practice location address for Earlean Blackwell is 1865 Waldrep Cir Se, Marietta, GA and can be reached out via phone at 678-491-0078.

Location: 1865 Waldrep Cir Se, Marietta, GA, 30060-4927
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1023677713
Provider Name
Earlean Blackwell
Credential
Provider Entity Type
Individual
Gender
Female
Address
1865 Waldrep Cir Se, Marietta, GA, 30060-4927
Phone Number
678-491-0078
Fax Number
Provider Enumeration Date
06/06/2019
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
1865 Waldrep Cir Se
City
Marietta
State
Georgia
Zip
30060-4927
Phone Number
678-491-0078
Fax Number
person
Provider Business Mailing Address Details
Address
1865 Waldrep Cir Se
City
Marietta
State
Georgia
Zip
30060-4927
Phone Number
678-491-0078
Fax Number
person
Provider's Taxonomy Details 1
Type
Residential Treatment Facilities
Classification
Residential Treatment Facility, Intellectual and/or Developmental Disabilities
Speciality
-
Taxonomy
320600000X
License No.
(Georgia)
Definition
A residential facility that provides habilitation services and other care and treatment to adults or children diagnosed with developmental and intellectual disabilities and are not able to live independently.
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