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Sid's Place Incorporated
Mental Illness Community Based Residential Treatment Facility in Ellenwood, Georgia
NPI 1174823595

Sid's Place Incorporated is a Mental Illness Community Based Residential Treatment Facility based in Ellenwood, GA. Sid's Place Incorporated practices in Ellenwood, GA. The NPI Number for Sid's Place Incorporated is 1174823595 and holds a License No. 031012928 (Georgia).

The current practice location address for Sid's Place Incorporated is 2742 Luke Dr, Ellenwood, GA and can be reached out via phone at 678-557-8969 and via fax at 404-521-4888.

Location: 2742 Luke Dr, Ellenwood, GA, 30294-3987
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1174823595
Provider Name
Sid's Place Incorporated
Credential
Provider Entity Type
Organization
Address
2742 Luke Dr, Ellenwood, GA, 30294-3987
Phone Number
678-557-8969
Fax Number
404-521-4888
Provider Enumeration Date
11/01/2010
Last Update Date
03/12/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
992605365A 05 GA
institution
Provider Business Practice Location Address Details
Address
2742 Luke Dr
City
Ellenwood
State
Georgia
Zip
30294-3987
Phone Number
678-557-8969
Fax Number
404-521-4888
person
Provider Business Mailing Address Details
Address
2742 Luke Dr
City
Ellenwood
State
Georgia
Zip
30294-3987
Phone Number
678-557-8969
Fax Number
404-521-4888
person
Provider's Taxonomy Details 1
Type
Nursing & Custodial Care Facilities
Classification
Assisted Living Facility
Speciality
-
Taxonomy
310400000X
License No.
031012928 (Georgia)
Definition
A facility providing supportive services to individuals who can function independently in most areas of activity, but need assistance and/or monitoring to assure safety and well being.
person
Provider's Taxonomy Details 2
Type
Residential Treatment Facilities
Classification
Community Based Residential Treatment Facility, Mental Illness
Speciality
-
Taxonomy
320800000X
License No.
031012928 (Georgia)
Definition
A home-like residential facility providing psychiatric treatment and psycho/social rehabilitative services to individuals diagnosed with mental illness.
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