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Willie Mae Berry Pugh
Intellectual and/or Developmental Disabilities Residential Treatment Facility in Hephzibah, Georgia
NPI 1144747437

Willie Mae Berry Pugh is a Intellectual and/or Developmental Disabilities Residential Treatment Facility based in Hephzibah, GA. Willie Mae Berry Pugh practices in Hephzibah, GA. The NPI Number for Willie Mae Berry Pugh is 1144747437 and holds a License No. (Georgia).

The current practice location address for Willie Mae Berry Pugh is 2013 Teal Court, Hephzibah, GA and can be reached out via phone at 706-790-4961.

Location: 2013 Teal Court, Hephzibah, GA, 30815-7951
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1144747437
Provider Name
Willie Mae Berry Pugh
Credential
Provider Entity Type
Individual
Gender
Female
Address
2013 Teal Court, Hephzibah, GA, 30815-7951
Phone Number
706-790-4961
Fax Number
Provider Enumeration Date
08/28/2017
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
2013 Teal Court
City
Hephzibah
State
Georgia
Zip
30815
Phone Number
706-790-4961
Fax Number
person
Provider Business Mailing Address Details
Address
2013 Teal Court
City
Hephzibah
State
Georgia
Zip
30815
Phone Number
706-790-4961
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.
()
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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